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Insulin and IGF-1 mediate their pleiotropic biological effects by binding to insulin and IGF-1 receptors (IR and IGF1R) on the surface of the cell (13)

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Additionally, if gut permeability is indeed increased in ME/CFS patients, microbes and antigens may be able to cross the epithelial barrier into surrounding tissue and blood, potentially crossing the BBB and altering the HPA axis (443)

Access this article Similar content being viewed by others References Aposhian HV (1997) Enzymatic methylation of arsenic species and other new approaches to arsenic toxicity