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Elevated HPHPA, a Clostridia metabolite measured on OAT, has been associated with altered dopamine-to-norepinephrine conversion and may be relevant in neurocognitive symptom presentations (Shaw, 2010)

The current evidence base points to several overlapping molecular pathways operating in parallel: VEGFR2/Akt/eNOS Angiogenic Signalling A primary mechanistic axis involves upregulation of vascular endothelial growth factor receptor 2 (VEGFR2), leading to activation of the Akt/eNOS (endothelial nitric oxide synthase) downstream pathway

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