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Disturbances in the intestinal endothelium, lymphoid atrophy, gut dysbiosis, and elevated inflammatory metabolites (TNF, specific pteridines, IL-1, IL-6 and IL-12, fecal calgranulin and myeloperoxidase) further compromise intestinal function [51, 106, 110,111,112] SAM-induced inflammation further inhibits micronutrient uptake, creating a downward spiral in SAM severity and increased morbidity and mortality [104, 113]

Numerous in vitro , in vivo , and clinical studies have been conducted to determine the immunomodulatory effects of Z

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doi: 10.1016/j.neuropharm.2015.11.003