Given the interaction between epitalon, DNA and histone proteins, we speculate that the tetrapeptide may trap proteins on the DNA and induce ALT activity
The mechanistic hypothesis: Semaglutide activates GLP-1R, appetite suppression, glycemic control Cagrilintide activates amylin receptors, appetite suppression via the area postrema, slowing of gastric evacuation Two independent mechanisms of appetite suppression a supra-additive effect In Phase 1b and Phase 2 trials the combination showed a stronger effect than either component alone : Semaglutide alone: 14.9 % (STEP-1) Cagrilintide alone (Phase 2): 10.8 % CagriSema combination (Phase 2): 15.6 % CagriSema Phase 3 (REDEFINE 1): 25.3 % CagriSema thus becomes the largest body-weight signal reported in the published incretin literature to date , stronger than Tirzepatide (22.5 % in SURMOUNT-1) and comparable to Retatrutide

According to the company, the formula was designed around a specific functional objective: formulated around butyrate-related digestive support mechanisms delivered through multiple simultaneous pathways - direct delivery, bacterial production, and microbiome prebiotic support
Ren JL, Wu HF, Wang WJ, Hu GM, Gu B, Zhang M, et al