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Alternatively, the HPA axis hypofunction might arise from several mechanisms, including chronic inflammation with elevated TNF- levels, a regulatory T cells response with increased IL-10 and transforming growth factor (TGF)-, heightened oxidative and nitrosative stress pathways, notably elevated nitric oxide (NO) production, and infection-related factors like LPS tolerance and viral infections affecting the HPA axis (see Table 2) [79]

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