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Binding copper allows the peptide to participate in multiple biological processes related to cellular communication, tissue repair and extracellular matrix maintenance

In one ME/CFS study, significantly lower levels of adrenocorticotropin (ACTH)/cortisol were found (430)

poor response to local anaesthetic

Following this, BH4 can be recycled back from its oxidized form, dihydrobiopterin, with the help of dihydrofolate reductase using NAD(P)H (182,183)

Limited clinical validation: Despite decades of research interest, DSIP has not progressed into wide-scale clinical adoption, which raises questions about consistency and reproducibility of effects