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44 The corticotropin (ACTH) stimulation test is used to diagnose a variety of adrenopathic conditions, including endogenous or iatrogenic hyperadrenocorticism, as well as spontaneous hypoadrenocorticism.42, 45, 46 As a screening test for the diagnosis of naturally occurring hyperadrenocorticism, the ACTH response test has a diagnostic sensitivity of approximately 80% to 85% and a higher specificity than the LDDS test.45, 46 In a study by Kaplan and Peterson, only 15% of dogs with nonadrenal disease exhibited exaggerated response to ACTH stimulation

Despite these advances, Gut-on-a-Chip models remain insufficient for studying intestinal first-pass metabolism because most current approaches focus on drug metabolism in host cells and do not incorporate gut microbiota as contributors to drug transformation and epithelial metabolic regulation (Table 1)

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