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This poor absorption is driven by extensive first-pass metabolism in the liver and active clearance by P-glycoprotein efflux pumps in the intestines, which actively push the berberine back out into the gut lumen

Additionally, the Receiver Operating Characteristic (ROC) curve confirmed the involvement of 2-oxoglutarate as a mitochondrial-related biomarker in distinguishing PD patients from HC (AUC = 0.94) (Supplementary Fig

Similarly, scores on UPDRS Part 1 ( p = 0.00079) and the PAS ( p = 0.00086) significantly changed over the course of the study

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