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However, C4 levels in IBS-D are not significantly correlated to mucosal permeability as assessed by urinary excretion of lactulose/mannitol, and in 23 patients with IBS-D, treatment with colesevelam tended to improve stool consistency but did not alter mucosal permeability as assessed by lactulose/mannitol excretion (173)

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In the paper, we explain the three different homeostatic mechanisms in one-carbon metabolism that keep the concentration of Hcy quite homeostatic

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