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It has been demonstrated that four phyla of lipopolysaccharide-producing Gram-negative bacteria, which includes the phyla Anaplasma, Aspergillus, Verruciformes , and Clostridium , have been identified as relatively abundant in the gut microbiota of diabetic nephropathy compared to the healthy group (Salguero et al., 2019)

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however, we evaluated the effects of nebulized NAC over an extended period of 12 weeks