Fig. 1. Schematic illustration of stress–corticotropin-releasing factor (CRF) induced neuroinflammation and barrier disruption with focus on the activation of hypothalamus–pituitary–adrenal (HPA) axis. HPA axis mediated production of cortisol alter gut microbiota, increase lipopolysaccharide (LPS), and impairs gut barrier via reorientation of tight junction proteins. Microbiota alteration also affects its metabolites, ie, short-chain fatty acids to modify epithelial barrier integrity, exacerbate immune cells activation, and add to psychiatric morbidities. ACTH, adrenocorticotropic hormone; DAMPs, damage associated molecular pattern; TLR4, Toll-like receptors-4; PAR-2, protease activated receptor-2; EEC, enteroendocrine cells.
© J Neurogastroenterol Motil
