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However, the leading theory behind PD pathogenesis is the accumulation of alpha-synuclein aggregates within cells, which trigger neuroinflammation and neuronal apoptosis (Kim et al., 2019)

Additionally, if gut permeability is indeed increased in ME/CFS patients, microbes and antigens may be able to cross the epithelial barrier into surrounding tissue and blood, potentially crossing the BBB and altering the HPA axis (443)