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In retrospect, these adverse effects closely mirror those observed during early GLP-1 development, where rapid systemic exposure and high peak concentrations produced unacceptable gastrointestinal symptoms

But failed to achieve FDA approval, leaving it in research-grade limbo

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These microbial shifts trigger cascading gutbrain disruption by impairing neurotransmitter signaling, suppressing SCFA production, weakening epithelial barrier integrity, and activating neuroimmune pathways, ultimately resulting in anxiety- and depression-like behaviors in rodent models (Tejkalov et al., 2023