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J Am Osteopath Assoc

It promotes neutrophil chemotaxis and degranulation leading to local inflammation in damaged tissues 37

Systemic metabolic alterations and their relationship to neuropsychiatric symptomatology PAIS, including long COVID, as well as CFS and IMD, share the characteristic of systemic metabolic disturbances, which may be a sign of underlying multi-organ inflammation and exhaustion [31], and consequently may contribute to neuropsychiatric symptomatology, as many metabolites can cross the bloodbrain barrier (BBB) [30, 58] (e.g., short chain fatty acids (SCFAs) derived from the gut microbiota such as acetate [40], amino acids such as tryptophan [52] and also carnitine/acetylcarnitine can cross the BBB via transporters [59])