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ATCC, CCL-131) and female human epithelial HeLa (ATCC, CCL-2) cells were maintained in MEM (Thermo Fisher Scientific), supplemented with 10% FCS, 2 mM L-glutamine, 1 mM pyruvate, and 1% penicillin-streptomycin at 37 C and 5% CO 2

In addition, lactulose converts freely diffusible ammonia into non-absorbable ammonium ions, thereby reducing intestinal ammonia absorption, while its cathartic effect enhances fecal nitrogen excretion and lowers systemic ammonia levels [122]

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