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Two primary strategies have been identified for enhancing antitumor immunity by counteracting T cell exhaustion: (i) reinvigorating the T pex population and (ii) supporting the differentiation of CTL-like exhausted T cells while avoiding the accumulation of terminal T ex subsets

For instance, studies have shown that chemotherapeutic agents like melphalan can directly disrupt ileal BA reabsorption (156), while other treatments reduce the abundance of key BA-metabolizing bacteria, such as those within the Clostridiales order