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Despite this, a substantial body of pre-clinical and limited clinical research has mapped DSIPs pharmacological effects across multiple systems, identifying several probable mechanistic axes including NMDA receptor modulation, adrenergic system regulation, MAPK/ERK cascade interaction, and mitochondrial respiration effects while acknowledging that the existence of an undiscovered DSIP-like endogenous peptide(s) may account for part of the DSIP-like immunoreactivity observed in tissue distribution studies

A 2025 meta-analysis of 14 stroke RCTs found neutral effects on mortality and serious adverse events

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