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However, a 2021 study by Sun et al

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Cellular assays have enabled detailed examination of second messenger dynamics, such as cyclic AMP generation and calcium mobilization, while animal models have provided insight into systemic signal coordination and feedback regulation along the hypothalamic pituitary axis

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( Nishida, et al 2018 ) Researchers in the Netherlands have stated "...in a state of inflammation, not only high levels of proinflammatory cytokines are produced but also altered levels of neurotransmitters, such as serotonin, a derivative of tryptophan metabolism, are detected in the gut." ( Waclawikov and Aidy 2018 ) So, we have another vicious cycle: disturbed microbiome inflammation low serotonin slow gut motility disturbed microbiome etc