The 4-amino-acid sequence is small enough that immunogenicity should be low, but excipients and impurities can cause reactions
In contrast, lower rates are observed in developing regions including Asia and Africa
Replication across independent research groups remains more limited in this area
Crucially, decreased IDO enzyme activity can disrupt tryptophan fermentation, affecting the gut microbiome and potentially leading to an impaired intestinal mucosal barrier, increased endotoxin translocation, and chronic inflammation
MN and FR supported to figure drawing and edited the manuscript
Simultaneously, glutathione-S-transferase (GST) activity decreases by 72%, reducing the cellular capacity to clear toxic metabolites (45, 46)