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However, the challenges for viral-mediated approaches are some of the largest in the clinical trial setting: the inflammatory response to viral particles, the tissue-unspecific uptake of the content, the lack of entry in target cells, oncogenic side effects, and the overall absence of effect in most clinical trials carried out are some of the aspects that make these types of approaches hard to implement [285,286,287,288]

Notably, the results of fecal microbiota transplantation from PPI-administered mice to germ-free mice demonstrated that the intestinal flora is closely related to variations in intestinal permeability