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Moreover, hormonal changes with aging such as insulin resistance, lower IGF-1 levels, and higher glucocorticoid levels can tilt the balance toward a catabolic state, meaning geriatric patients often have a blunted anabolic response even with adequate nutrients [69, 70]

Probiotics modulated the expression of several genes, reduced cytokine secretion, and reduced aberrant protein aggregation

Further research is needed to optimize the efficacy and safety of these therapeutic strategies and to translate preclinical findings into clinical applications for individuals with COPD (116)