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4.3 Regulating the gut microbiota and immune system When the IEB is damaged, the permeability of the IEB increases, lipopolysaccharides and other endotoxins produced by bacteria can activate the peripheral immune system, activate immune cells and related signaling pathways, promote the release of inflammatory factors and cause systemic inflammation, and also promote the migration and infiltration of peripheral immune cells to the brain, leading to central nervous system inflammation through the blood-brain barrier (BBB) (Tack et al., 2023)