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The interplay of local (within the diseased liver) and systemic inflammation, stemming from portal hypertension and alterations in the gut microbiome, alongside heightened levels of circulating cytokines, disrupts hepatic vagal neurogenic responses and impacts cerebral endothelial cells, giving rise to neuroinflammation

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Dependent on the form of ADT used, build-up of steroid precursors occurs that are shunted to the synthesis of other steroids, such as progesterone (e.g., treatment with CYP17A1 inhibitor abiraterone), some of which can stimulate CaP progression via co-occurring accommodating changes in AR [35]

Richards et al

Heterogeneity of diagnoses presenting as cyclic vomiting

This personalized approach holds promise for improved treatment efficacy and reduced side effects in PA patients