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Dysbiosis promotes a shift in TRP metabolism away from 5-HT and toward KYN, QA, and 3-HK, while simultaneously impairing intestinal barrier integrity and driving low-grade systemic inflammation, exaggerated cortisol reactivity, HPA-axis dysregulation, visceral adiposity, and cardiometabolic risk all features commonly comorbid with depression [178,179,180,181,182]
Clinical implications and practical recommendations In patients with T2DM and established heart failure, SGLT2 inhibitors currently have the strongest evidence base for improving HF outcomes and should be prioritized when not contraindicated [8, 11, 45]
This may help prevent increases in appetite often associated with weight loss that make weight maintenance challenging
BPC 157 has been investigated for its potential role in modulating nitric oxide signaling and vascular growth factor pathways
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