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Moreover, ROS directly stimulates the release of pro-inflammatory cytokines and activates the nuclear factor B (NF-B) pathway to cause inflammation ( In the three-hit hypothesis of X-ALD, oxidative stress is described as the first hit to cause axonal injury of AMN, or subsequently induce inflammatory demyelination and cell death of CALD, triggered by stochastic factors such as lipid peroxides, environmental factors, and genetics ( in vivo / in vitro studies have demonstrated that drugs targeting redox imbalance and inflammation effectively improve symptoms and prevent disease progression ( This study introduces the relationship between the X-ALD and oxidative stress and inflammation