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Excessive ROS can overwhelm the endogenous antioxidant defense system, leading to oxidative damage, including lipid peroxidation reflected by elevated MDA levels [55-57]

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Concurrently, elevated pyruvate kinase M2 (PKM2) expression upregulates Bcl-xL [59], while mesenteric adipose tissue (MAT) and lamina propria lymphocytes (LPL) show characteristic apoptotic dysregulation with increased Bcl-2 and decreased BAX expression [60, 61]

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Supporting mitochondrial function through peptides like SS-31 while simultaneously promoting neurogenesis and reducing inflammation through other peptides represents a multi-target approach to conditions that have resisted single-target therapies for decades