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The bidirectional relationship between the enteric nervous system (ENS) and central nervous system (CNS) under the mediation of the gut-brain axis control the gastrointestinal functioning

The therapeutic era of peptides began in 1921 with the discovery of insulin, a breakthrough that revolutionized diabetes and helped establish biologic therapies in medicine 1 Since then, peptide hormones like oxytocin and human growth hormone (GH) have entered clinical use, and glucagon-like peptide-1 (GLP-1) receptor agonists such as semaglutide are now widely prescribed for obesity and metabolic diseaseconditions increasingly recognized for their effect on orthopaedic outcomes

The high levels of metabolites related to the thiomethyl shunt suggest an excessive production of NAQPI-derived glutathione conjugates (unseen so far in the other individuals)