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Microorganisms in the intestines can pass through the intestinal barrier and enter the portal vein lumen when the permeability of the intestinal barrier decreases

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Because KPV is transported by PepT1 (a di/tripeptide transporter expressed in the intestine), it can be absorbed intact from the gut

however, an increase in gastrointestinal adverse events was observed in the tirzepatide group compared with dulaglutide