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Intestinal permeability in disorders of gut-brain interaction: from bench to bedside

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For instance, it has been shown that psychological stress leads to HPA-dependent monocyte-mediated exacerbation of gut inflammation (246, 247), and can alter the composition of the microbiota (248), a phenomenon possibly due to the presence of neurotransmitter receptors on bacteria (245)

This indicates that the observed associations are not driven by demographic imbalance and that residual confounding or collider bias related to age and sex is unlikely to explain the results