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Constipation may also predispose bacteria to reach excessive populations, particularly Lactobacillus species that can execute tyrosine decarboxylation, L-DOPA by converting it into dopamine in the gut hence limiting its release into the bloodstream and causing motor fluctuations (Menozzi and Schapira, 2024)

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Studies conducted on mouse fibroblast cells treated with TER199 revealed elevated expression levels of -glutamyl cysteine synthetase and the multidrug resistance-associated protein, MRP1

However, long-term use of levodopa can lead to motor complications, and the development of non-motor symptoms remains a challenge