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Notably, serum-based fibrosis scores (e.g., ELF test incorporating HA, PIIINP, TIMP-1) have already gained FDA breakthrough designation and are integrated into ongoing phase II/III clinical trials for MASLD drug development [341]

The 2024 NICE Guideline NG239 from the United Kingdoms National Institute for Health and Care Excellence similarly distinguishes between patients who can be managed with oral therapy and those who require intramuscular treatment

Indeed, ZO-1 switching could occur via either MLCK-dependent or MLCK-independent mechanisms, which are slow and fast kinetics, respectively

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