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The pathophysiology of DOX-induced POI is complex, but numerous factors have been proposed to be linked to the onset and development of ovarian dysfunction, including free radical-mediated lipid peroxidation, oxidative stress, mitochondrial malfunction, increased proinflammatory release of cytokines, and granulosa cell apoptosis 12,13,14

Therefore, the identified virulence-related genes in M22 should not be interpreted as conventional virulence factors, but rather as adaptive elements that enhance the strains ability to persist and thrive in ecological niches such as the gastrointestinal tract ( Genes associated with hostpathogen interactions ( n = 475) and membrane transport proteins ( n = 406, including 147 ABC-type transporters) were identified, Transporter proteins play a crucial role in bacterial life by facilitating nutrient uptake and providing defense against internal and external stresses ( Strains that cause hemolysis can lead to sepsis in the host ( in vitro and in vivo

These individuals were queried as to their melatonin use and placed into either the melatonin group or the control group

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