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Additionally, metformin monotherapy may be a suitable alternative for adolescent girls who are reluctant to use oral contraceptives

Regarding management, a wide range of possible treatment options have been proposed that cover different pathophysiological mechanisms, including improvement of natural killer cell function, elimination of autoantibodies, immunosuppressants, antivirals, antioxidants, mitochondrial support, and mitochondrial energy generation [28]

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For example, medications like semaglutide and tirzepatide have demonstrated significant weight loss in people with obesity by helping control hunger and reduce calorie intake

10.1089/ars.2013.5371 293 PasparakisM.VandenabeeleP

coli GI: Gastrointestinal HLA: Human leukocyte antigen HT: Hydroxytryptamine IBD: Inflammatory bowel disease IEC: Intestinal epithelial cell IFN: Interferon IG: Immunoglobulin IL: Interleukin IR: Immune response LAP: Listeria adhesion protein LPS: Lipopolysaccharide LTA: Lipoteichoic acid MAC: Microbiota-associated carbohydrates mTG: Microbial transglutaminase Muc2: Mucin-2 NF-B: Nuclear factor-kappa B NSAIDs: Non-steroidal anti-inflammatory drugs PAD: Peptidylarginine deiminase PAMP: Pathogen-associated molecular pattern PCBs: Polychlorinated biphenyls POPs: Persistent organic pollutant PPI: Proton pump inhibitor RA: Rheumatoid arthritis RF: Rheumatoid factor SCFAs: Short-chain fatty acids SI: Small intestine SLE: Systemic lupus erythematosus Th17: T helper 17 TJ: Tight junction TLR: Toll-like receptor TNF: Tumour necrosis factor tTG: Tissue transglutaminase T1D: Type-1 diabetes ZO: Zonula occludens References Abreu MT (2010) Toll-like receptor signalling in the intestinal epithelium: how bacterial recognition shapes intestinal function