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Vedolizumab, a gut-selective anti-integrin biologic approved for ulcerative colitis and Crohn’s disease, interacts with gut microbiota both directly and indirectly. Its primary action is to block lymphocyte trafficking into gut tissue by blocking the α4β7 integrin, thereby reducing mucosal inflammation and allowing microbiota-driven restoration of epithelial and immune homeostasis. Vedolizumab indirectly alters the immune–mi…