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In colonic epithelial cells, TMAO induces NF-B-dependent upregulation of IL-8 and TNF-, disrupting tight junctions and increasing permeability (17)

In addition, ketamine induces a state of hypofunction of the NMDA receptor and its downstream signaling pathways, leading to disruption of glutamate activity toward other receptors, which is linked to mitochondrial dysfunction causing hyperstimulation (15, 88)

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