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As the cells become weaker, they become more vulnerable to damage or apoptosis (cell death) from even small reductions in perfusion, which can occur if the individual becomes dehydrated or overheated, undergoes surgery, has a drop in blood pressure, engages is excess physical activity, has untreated sleep apnea, or experiences a traumatic shock

But he points out that there are a few theories floating around

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They are produced by keratinocytes in the epidermis and work by disrupting microbial membranes