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Nevertheless, the entry of peripheral ghrelin into the brain is limited and potentially binds only to areas of the brain that are less protected by the bloodbrain barrier like the arcuate and the area postrema in the brain stem (Banks et al., 2002
Clinical studies suggest that GLP 1 & GIP therapy may be even more effective than GLP 1 alone, with patients often experiencing greater weight loss in a shorter period
10.1016/j.mib.2013.06.008 218
Thus, if neuroinflammation remains over time and the astrocyte-neuron L-lactate shuttle cannot cope with chronic oxidative stress, this would result in chronic PARP-1 activation with decreased NAD levels within the cell (198, 202)
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