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and bioorthogonal conjugation of immunomodulators to the EcN surface, where dissolution of an enteric coating in the intestine exposes the conjugates to drive macrophage polarization from pro-inflammatory M1 to anti-inflammatory M2, complementing the probiotic's intrinsic effects (Peng et al., 2024)

Shaking introduces cavitation forces (micro-scale pressure waves) that denature peptide chainsexpect 2535% bioactivity loss even if the solution appears clear

Oxidative damage to the heart often leads to heart disease like stroke, heart attacks, and other life-threatening conditions

It also differentiates painful versus painless DN, showing greater nerve loss in symptomatic patients [42]