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Currently, clinical management of SIC remains challenging, mainly due to the complexity of its pathogenesis and the lack of targeted therapies. Although the specific etiology of SIC is not yet fully understood, existing studies have revealed several vital pathological processes that are intertwined and contribute to the progression of the disease. This narrative review summarizes the existing pathogenesis of SIC, which involves multiple aspects including the inflammatory response, mitochondrial dysfunction, cell death mechanisms, immune regulation, and calcium homeostasis imbalance. 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