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At the epithelial level, the drug-induced expansion of butyrate-producing bacteria becomes structurally pivotal: butyrate serves as the primary fuel for colonocytes, stimulates tight junction assembly (upregulating proteins such as occluding and zonula occludens-1 [ZO-1]), and induces mucin production from goblet cells, thereby thickening the protective mucus layer

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The mechanism underlying this association likely relates primarily to rapid weight loss rather than direct drug toxicity