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This profile not only involves high levels of PAI-1 and STAT3 as previously described, but also includes low levels of glutamine and NAD + , coupled with overproduction of hyaluronan (HA)

M.VisigalliR.BarilliA.FerrariF.BianchiM

Mar 2015;27(3):397-405

Differential Diagnosis Considered etiologies included: Primary psychiatric disorder Neuroinflammatory or neurodegenerative disease Endocrine dysfunction Chronic infection (Lyme disease, EBV) Chronic inflammatory response syndrome (CIRS) Environmental toxin exposure (including mycotoxins) The acute onset, lack of psychiatric history, and environmental correlation made a primary psychiatric etiology less likely

FIGURE 2 3MST is another enzyme known to be involved in H 2 S biogenesis, and is also reported to generate persulfidated species (Pedre and Dick, 2021)

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