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Consistent with this, boosting shuttle activity (via overexpression of their enzymes) decreased lactate accumulation and diverted more glucose into citrate with no impairment of proliferation 186 , also in agreement with an earlier notion that the Warburg effect is a consequence of limited NADH-shuttle throughput rather than a driver of proliferation 187

Furthermore, a reduction in symbiotic bacteria such as Faecalibacterium prausnitzii and overgrowth of pathogenic bacteria have been observed in the gut of IBD patients, with host-associated gene mutations impairing the recognition and clearance of the gut microbiome

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Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: a systematic review and meta-analysis of randomised trials