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In vitro , treating human kidney 2 (HK-2) cells with butyrate under high glucose conditionsmimicking the diabetic renal environmentsignificantly suppresses NLRP3 inflammasome activation and IL-1 release, thereby reducing tubular inflammation ( in vivo findings in non-obese diabetic Akita mice reveal that acetate supplementation mitigates glomerular injury, evidenced by preservation of WT1-positive podocytes and reduced glomerular collagen IV deposition, indicating direct renoprotection at the structural level ( 4.2 Blocking renal fibrosis: epigenetic and metabolic strategies Preventing kidney fibrosis requires disrupting the TGF-/Smad pathway through two converging mechanisms: epigenetic regulation and metabolic reprogramming (113, 114)

Unrelated to her CLS therapy, the patient was started on semaglutide due to weight gain likely associated with prolonged steroid use

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Negative control sections were done by substituting ezrin primary antibodies by normal serum of rabbit