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When starting a new medication, the body often goes through a period of adjustment, during which side effects can occur

Notably, -synuclein aggregation has been detected in the enteric nervous system (ENS) prior to CNS involvement in a subset of patients, suggesting a potential gut-to-brain propagation pathwaythough this remains controversial and may represent independent parallel processes rather than sequential spread

According to inflammatory cytokines, transforming growth factor-beta, tumor necrosis factor-alpha (TNF), interleukin-6 (IL-6), and interleukin-8 have been most frequently implicated in this mechanism since they promote the movement of polymorphonuclear and mononuclear leukocytes towards the inflamed tissue, thus activating liver stellate cells and generating increased collagen synthesis and fibrosis development [2023]

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