The emphasis on the role of the mitochondrial melatonergic pathway also allows for the incorporation of recent data highlighting the pathophysiological role of chitinase-3-like protein 1 (CHI3L1), also known as YKL-40, in ALS pathophysiology [178] as well as in an array of other medical conditions, including neurodegenerative disorders more widely [179], asthma [180], autoimmune disease [181] and cardiovascular disorders [182]. This evidence concerns the gene CHI3L1 and autoimmune disease.