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4.1.2 HPA axis dysfunction and PTSD Though the HPA axis maintains the bodys endocrine balance by precise negative feedback mechanisms, dysfunction in this system can lead to severe physiological and psychological problems ( Abnormal cortisol secretion influences various physiological processes, comprising neurotransmitter balance and immune responses, and these changes may deepen emotional symptoms in PTSD patients, such as irritability, anxiety, and depression ( To sum up, dysregulation of the HPA axis function plays a vital role in the pathophysiology of PTSD

demonstrated significant age-dependent variations in the composition and regenerative remodeling properties of porcine small intestinal submucosa extracellular matrix (SIS-ECM) bioscaffolds

When this balance is maintained, harmful inflammation is less likely to occur

doi: 10.1016/j.plaphy.2018.07.014 5 DemmigB.WinterK.KrGerA.CzyganF.-C

These studies tend to focus on the gut microbiome and its complex interplay with the immune system