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Consistent with the gut microbial changes, PAH patients had relatively lower plasma levels of SCFAs and secondary bile acids. PAH patients also had enrichment of species with the microbial genes that encoded the proinflammatory microbial metabolite trimethylamine. The changes in the gut microbiome and circulating microbial metabolites between PAH patients and family controls were not as substantial as the differences between PAH patients and healthy controls. PAH patients have proinflammatory gut dysbiosis in which lower circulating SCFA
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