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Similarly, growth hormone (GH) may be related to ALS as one trial found that ALS patients had impaired GH secretion compared to healthy controls (Morselli 2006)

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The hypothalamicpituitaryadrenal (HPA) axis is related to psychological and physical stress and regulates multiple physiological systems including the gut permeability, causing bacterial translocation, and release of messenger substances, which affects the intestinal barrier and BBB permeability (Vagnerov et al., 2019

When the HPA-axis is activated, it triggers the release of corticosterone hormone that can reduce the levels of immunoglobulin A (IgA) and toll-like receptors (TLRs) [50]