The primary impact on cytokines depends on the NF-κB and nitric oxide pathway, both of which promote IBD development.419 In a multicenter clinical trial, 5-hydroxytryptophan as one kind of antidepressant significantly regulates depression, anxiety, and stress scores, but not improves IBD-related fatigue (NCT03574948).420. This evidence concerns the gene NFKB1 and irritable bowel syndrome.