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The intestinal epithelium together with gut-associated lymphoid tissue and the neuroendocrine network work at regulating transport of environmental or dietary antigens from the intestinal lumen into the sub-mucosa.[2] Dysregulation of the mucosal barrier leads to leakiness of antigens and other macromolecules into the host to initiate systemic inflammation and immune activation which in turn influences tolerance and immunity

Neuropsychiatric manifestations such as mood lability, aggression, or depression have been documented, underscoring the need for mental-health screening