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For example, Escherichia coli secretes -glucuronidase, which facilitates the conjugation of serotonin with glucuronic acid to form the water-soluble metabolite 5-hydroxytryptophan glucuronide (5-HTG), thereby enhancing its excretion ( Clostridium scindens upregulates monoamine oxidase A (MAO-A) activity, promoting the oxidative deamination of serotonin into the inactive metabolite 5-hydroxyindoleacetic acid (5-HIAA) (Li et al., 2025)

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For competitive athletes, hexarelin (also called examorelin) is explicitly named as a prohibited growth-hormone-releasing peptide under WADA's Prohibited List in category S2 (Peptide Hormones, Growth Factors, Related Substances and Mimetics), banned at all times as a non-specified substance carrying a default four-year sanction

It indicated patients with PNP may gain benefit from ALC administration