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2.4 Definition of evidence grades To rigorously assess the pharmacological causality linking botanical interventions, gut microbiota, and RA outcomes, we stratified studies based on the completeness of the experimental chain: Level A (Closed-Loop Causal Evidence): Studies that establish both the necessity of the microbiota (via antibiotic depletion, ABX) and the sufficiency of specific microbial mediators (via Fecal Microbiota Transplantation [FMT] combined with metabolite rescue or in vivo pathway blocking)

Keywords: multimodal treatment, penile curvature, penile injections, antioxidant supplementation Introduction Peyronies disease (PD) is a chronic inflammatory disease involving the tunica albuginea surrounding the corpora cavernosa of the penis