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Tamoxifen (ICI 47699) is an orally active, selective estrogen receptor modulator (SERM)

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reported that SALL2 was significantly downregulated during tamoxifen therapy, this led to independent ER tumor growth and it conferred ER resistant phenotype in ER + cancer cells

Gut dysbiosis and disrupted intestinal barrier function could worsen pulmonary symptoms, augment neurological or hepatic inflammation through translocation of endotoxins and bacteria via portal veins 239,240,241