“…In conclusion, a significant decrease in estrogen levels disrupts immune homeostasis, particularly the levels of the immune factors TNF-α, IL-1β, IL-4, IL-6, IL-10 and IL-18 through the ERα/ERβ/GPER-associated NLRP3/NF-κB signaling pathway, which involves many signaling molecules, such as TLR2, TLR4, P2X7R, SIRT1, CREB, MS-KIF18A, PI3K, AKT, Gs, cAMP, PKA, PJA1, Serpina3n, Src, and MMP-9 [ 19 – 24 , 41 , 43 , 44 , 47 – 49 , 52 , 54 – 56 , 58 ]. Subsequently, the increase of inflammatory cytokine levels causes BBB destruction [ 25 , 62 – 74 , 165 ], the dysfunction of neurotransmitters such as 5-HT [ 80 – 85 ], DA [ 86 – 97 ], NE [ 98 – 105 ], GABA [ 29 , 30 , 106 – 113 ] and Glu [ 79 , 114 – 121 ], BDNF deficiency and dysfunction [ 26 , 128 – 135 ], and attenuation of neuroplasticity [ 136 – 146 ], which are key factors in the onset and progression of depression (Fig. 10 ).…”