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Although a clear mechanistic perspective is lacking, it can be conceptualized that gut microbial dysbiosis (and its metabolites) modulates innate and adaptive immune players by recruiting immune secreting cells from the appendix, thereby priming the immune system for an enhanced inflammatory response and a possible source of -synuclein misfolding (Masahata et al., 2014

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The released acid, by penetrating the intestinal wall, lowers its local pH, thus preparing the small capsule containing the peptide and, in our case, the absorption enhancer which is carnitine