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Some of the possible factors that are abundant in CS are polyaromatic hydrocarbons (PAHs) that are inducers of cytochrome P450s and are well known sources of reactive oxygen species [28]

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

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