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At the pathological mechanism level, animal model experiments have verified direct nephrotoxic effects of metabolites, with relatively substantial evidence in this domain (102, 112)

The primary molecular actions relevant to skin are: modulation of TGF- signaling (upregulating TGF-1 for collagen I/III synthesis while suppressing TGF-2 to prevent scarring), decorin upregulation for orderly collagen fibril assembly, MMP suppression paired with TIMP upregulation to preserve ECM integrity, and copper-dependent lysyl oxidase activation for collagen crosslinking

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Mike Reinold: That sounds like general counsel wrote that for a pharmaceutical company