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Semaglutide is a GLP-1 receptor agonist that enhances insulin secretion, slows gastric emptying, and suppresses appetite through the GLP-1 receptor

Butyrate acts blocks the IL-6/STAT3/IL-17 and TLR2-MyD88-NF-B pathways, and bidirectionally regulates cytokine secretion, Specifically, it upregulates anti-inflammatory factors such as IL-4 and IL-10 and downregulates pro-inflammatory factors such as CRP, IL-8, IL-12, and TNF- (66, 67, 91, 92)

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At very high concentrations, it may inhibit monoamine oxidase slightly, but this effect is not clinically relevant at typical doses

In patients who do not respond to an adequate trial of medication, clinicians should assess medication adherence, confirm that nonpharmacologic management has been maximized, and exclude other conditions that may need additional intervention

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