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The outer layer contains a variety of microorganisms, the inner layer is virtually free of microorganisms, and there is only a single layer in the small intestine in which the PAN cells located in the small intestine secrete antimicrobial peptides, defensins and other immunomodulatory proteins that limit the attack of bacteria and harmful substances on the intestinal epithelial cells (Mu et al., 2017

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During the tirzepatide shortage period (roughly mid-2023 through late 2024), compounding pharmacies were permitted under FDA enforcement discretion to produce copies of commercially available tirzepatide to help meet patient demand

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