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In summary, both direct design relying on mechanistic knowledge and available structural data from the oxytocinase subfamily of M1 aminopeptidases as well as iterative manipulations of the parent peptide Ang IV, involving insertion of unnatural amino acids as -amino acids, macrocyclizations and various structural simplifications have provided highly potent selective Ang IV peptidemimetics inhibiting IRAP

doi: 10.1016/j.bcdf.2024.100401 30

Challenges comprise of standardized assessment of treatment outcomes, antioxidant selection and dosage issues, and ongoing observation and evaluation of long-term effects

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So, I, the patient, am left to do the entire research, differential diagnosis, and treatment plan by myself, trying to integrate the feedback from the various specialists and triangulate the root-cause from amongst the various sub-specialists