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For current practice, the most defensible use of GLP-1RAs is as a time-bounded metabolic optimization strategy in women with meaningful obesity/insulin-resistance burden, with reproductive endpoints interpreted as potential downstream gains rather than guaranteed direct effects (17, 111, 112, 124)

This feedback loopfibrosis enabling SIBO, and SIBO amplifying fibrosistypifies the fibro-inflammatory circuit that underlies gastrointestinal involvement in SSc

In KLOW, KPV simultaneously suppresses inflammatory interference

Therefore, we assume that other than racial predisposition, hormonal stimulation and susceptibility to abnormal pigmentation could be a cause of PFPT