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Complementary metabolic regulation research utilizes mitochondrial-derived peptides like MOTS-c, which activates AMPK signaling and modulates cellular energy homeostasis through mitochondrial-nuclear communication

3.1.2 Potential mechanisms Numerous studies have demonstrated that loss of tear film homeostasis is the central mechanism of DED (31)

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Melatonin mitigates oxidative stress, inflammation processes, and cell apoptosis by upregulating the Nrf2 signaling pathway and downregulating COX-2 protein levels (135), as well as SOD, GPx, CAT, and Bcl-2 activities (136)

The results did not reach the double-digit percentage reductions seen with incretin peptides