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Metabolomic studies have shown accumulation of TCA cycle intermediates (e.g., citrate, succinate, -ketoglutarate) in alveolar tissue, impairing energy metabolism efficiency

Concurrently, a reduction in the diversity of the intestinal microbiota was observed, characterized by a decrease in the relative abundance of Bacteroidetes and an increase in Proteobacteria

It also modulates the activity of matrix metalloproteinases (MMPs) and their inhibitors, supporting balanced collagen remodeling rather than excessive breakdown or fibrosis