Current mainstay interventions, including intensive lifestyle modification and bariatric surgery, demonstrate suboptimal and often unsustainable long-term efficacy in this genetically defined population, highlighting a critical unmet need for effective, accessible, and durable pharmacological strategies
The receptor question is itself contentious: integrin V5 has been proposed as a functional receptor mediating irisin effects on bone and adipose tissue, and V3 integrin has been implicated in neuroprotective effects, yet neither has been universally accepted as a bona fide irisin receptor, and the binding affinities reported vary across experimental systems ( 6.3 METRNL and immunemetabolic coupling In Section 4.3, Meteorin-like protein (METRNL) was discussed in the context of metabolic peptides, which also occupies a position at the intersection of muscle, adipose tissue, and immune signaling
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