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This also suggests that GLP-1RAs with distinct rates of receptor internalisation and lysosomal targeting might differentially regulate the kinetics of this engagement, so that slow GLP-1R internalising compounds are expected to trigger initially reduced VAPB interactions, which might however paradoxically result in prolonged VAPB engagement over time, and therefore potentially lead to sustained ER signalling, as these biased compounds are also associated with reduced lysosomal degradation from the pool of internalised receptors 18,24

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Dorothy Shulman for her help and contribution to this paper

Such dysfunctional metabolic sequelae are cumulative outcomes of virus-induced HMRD involving about 10 divergent pathophysiological mechanisms, comprising of both virus-derived virulence factors as well as a multitude of extreme innate host responses

There is no workaround, no lower-energy setting, no topical that neutralizes this risk while Melanotan effects are still active in the skin