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These microbial changes correlate with higher lipopolysaccharide (LPS) and lower superoxide dismutase-1 levels (59, 60), which can lead to microbial translocation, systemic inflammation, and increased permeability of both the intestinal and blood-brain barriers (BBB), creating a vicious cycle (61–65)

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doi: 10.1038/s41577-019-0203-y 3 MacIverNJMichalekRDRathmellJC