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Neutrophils and monocytes are the first to arrive at the site of cardiac injury, releasing reactive oxygen species (ROS) and proteases aimed at removing the cause of the damage ( Several signaling pathways are involved in these inflammatory processes, such as the TNF-NF- B pathway, which plays a role in heart infection and injury, and the caspase-1 inflammasome pathway, which is activated by oxidative stress ( HIVAC is multifactorial, involving viral-mediated mechanisms, immune dysregulation, and the indirect effects of opportunistic infections

Table 6 Metabolic outcomes of alkaline water interventions in human and animal studies