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Endothelial dysfunction has been demonstrated in vivo (306, 311), in the large vessels of ME/CFS patients (307, 311) through flow-mediated dilation (FMD) and in the microcirculation through post-occlusive reactive hyperaemia

Furthermore, high serum levels of TMAO can increase the production of tumor necrosis factor- (TNF) through the NFB signaling pathway

GSH) and the ratio of the reduced and disulfide forms (GSH/GSSG), significant indicators of the antioxidative ability, were apparently inhibited by phosgene exposure

In particular, LEAP2 (liver-expressed antimicrobial peptide 2), an endogenous antagonist of the ghrelin receptor GHSR, has emerged as a potential target for mitigating the weight regain often observed after discontinuation of GLP-1-based therapies [22,23]

Pregnancy and breastfeeding are also contraindicated due to a lack of safety data for systemic use in these populations

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