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Multiple factors contribute to mitochondrial complex I dysfunction, affecting energy metabolism and exacerbating oxidative stress, which damages neurons, and PINK1/Parkin-mediated mitochondrial autophagy is disturbed by mutations in PD-associated genes and aberrant expression of deubiquitinating enzymes, imbalances in mitochondrial dynamics, and aberrant interactions with other organelles, which all contribute to the progression of PD [159]

Similarly, a muscle-dwelling nematode ( Trichinella sp iralis) infection causes noradrenaline decline in rats intestines, myenteric plexi, which persists up to 100 dpi (319)

Chem-Biol Interact 159:1846

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grade 1, mild inflammation (slight increase in mononuclear cells)

In summary, IR/hyperinsulinemia, hyperandrogenism, obesity, chronic inflammation, and OS engage in a complex, synergistic interplay