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This microbial shift disrupts multiple gut–brain pathways simultaneously: these shifts coincided with gut barrier disruption (elevated serum endotoxin), triggering elevated hippocampal cytokines (IL-6, TNF-α), which in turn suppress Tph2 expression and induce Tph2 hypermethylation (suggesting neuroinflammation and serotonergic suppression), ultimately manifesting as anxiety and depression-like behaviors (Buchenauer et al., 2023)

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