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(2016) 4:e1153568

In type 2 diabetes, the reduced expression of HO-1 will increase the production of ROS, leading to oxidative stress and inflammatory reaction, further aggravating cell damage (Table 2)

The accumulation of these toxic substances not only directly damages the gut barrier function but also induces systemic inflammatory response syndrome by over-activating the immune system, forming a vicious cycle of toxin accumulation-inflammation exacerbation. It is worth noting that such toxins can also interfere with the neuroendocrine regulation of the gut, aggravating gastrointestinal dysfunction and disrupting microbiota homeostasis

Ji et al., 2020)