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First, PPI-induced hormonal changes, such as hypergastrinemia and hyperparathyroidism, affect intestinal osmolality as well as calcium and phosphorus metabolism, which in turn affect the intestinal flora (Yang and Metz, 2010)

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Semaglutide is a GLP-1 receptor agonist that enhances glucose-dependent insulin secretion, suppresses appetite via central nervous system pathways, and delays gastric emptying

[5] [7] At dosages exceeding 5 grams, there is a potential risk for more severe adverse effects, including renal dysfunction, blood toxicity, and neurological symptoms

Tumor necrosis factor-alpha (TNF-alpha), a cytokine involved in systemic inflammation, along with matrix metalloproteinase-2 (MMP-2) and matrix metalloproteinase-9 (MMP-9) enzymes that break down extracellular matrix proteins might potentially influence both the inflammatory processes and the remodeling of tissues