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This ERK-without-Akt profile supports cellular proliferation and survival while maintaining cells in a proliferative rather than differentiated state contrasting sharply with IGF-1s PI3K/Akt/mTOR-dominant signalling, which drives protein synthesis and differentiation

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This step depends on microbial enzymes like TMA lyases, with bacteria from genera such as Clostridia and Eggerthella contributing significantly [1]