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Ashwagandha affects monoaminergic systems indirectly by normalizing hyperactivity of the HPA axis and modulating GABAergic tone, which consequently enhances the balance of serotonergic and dopaminergic systems (7, 8)

Results at 48 weeks were remarkable

Finally, 17-hydroxysteroid dehydrogenase HSD17B1 can reduce dehydroepiandrosterone to androstenediol

Its expression is elevated in COPD lung tissue and can be activated via three pathways: CS-induced ROS activating the PI3K-AKT pathway, macrophage TCA cycle disruption leading to succinate accumulation, and the PTGES-AKT pathway (83, 84)