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5.4 Combination therapy strategies Due to signaling pathway redundancy, monotherapy targeting LPA metabolism may have limited efficacy, positioning combination therapy as a critical direction

A landmark review by Pickart and Margolina in Biomolecules confirming GHK-Cus broad gene regulatory influence on tissue repair pathways supports its complementary role alongside metabolic interventions like NAD+ therapy

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Furthermore, ulinastatin is a serine protease inhibitor that inhibits trypsin and is clinically used to treat pancreatitis, disseminated intravascular coagulation, shock, and sepsis [130]

Individuals at risk of vitamin B12 deficiency include older adults, people with gastrointestinal disorders, those who have had gastrointestinal surgeries, individuals on a strict vegan diet, individuals who take metformin for blood sugar control, and people taking proton pump inhibitors for chronic heartburn