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Reed et al

Peptides occur naturally in the foods we eat and within our own cells

Proc Natl Acad Sci USA 107(38):1650016505

TMAO activated the expression of the inflammatory mediator high mobility group box 1 (HMGB1), which stimulated multiple receptors such as toll-like receptor 4 (TLR4), thus mediating extracellular signal-regulated kinases 1 and 2 (ERK1 and ERK2) and the NF-B signaling pathway (82)

[DOI] [PubMed] [Google Scholar] 257.Lee W-R, Shen S-C, Pai M-H, Yang H-H, Yuan C-Y, Fang J-Y

As you can see, acetyl-L-carnitines ability to reduce pain and support peripheral nerves makes it a key component in healing for diabetic neuropathy