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While ROS can function as second messengers regulating cellular reproduction, growth, differentiation, and signaling when maintained at optimal concentrations and dynamic equilibrium, exceeding critical ROS thresholds induces oxidative stress, leading to DNA damage, protein denaturation, and lipid peroxidationkey factors in CHD development

Tubulin, the constituent of these microtubules, undergoes a diverse array of PTMs including acetylation, detyrosination, polyglutamylation, polyglycylation, phosphorylation, polyamination, SUMOylation, glycosylation, arginylation, methylation or palmitoylation

doi:10.1146/annurev.biochem.74.082803.133524

This tells the payer that this is a medically necessary procedure.