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Wei and colleagues (Wei et al., 2022) recently discovered that GLP-1 receptor activation inhibits this signaling pathway by modulating ROCK activity, leading to a reduction in the phosphorylation of MLC, which stabilizes the endothelial cell cytoskeleton and tight junctions by upregulating the expression of tight junction proteins such as Occludin and ZO-1

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For people who are legitimately on these medications at full-dose , Wegovy and Zepbound allow dose pauses and slower steps for tolerability, while keeping the maintenance target in sight

The clinical significance of this is unclear for occasional use of slightly degraded medication, but it reinforces the principle of not knowingly using compromised product over extended periods