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Despite roughly five decades of work, no DSIP-specific binding site has been cloned, no DSIP gene has been isolated, and no signal-transduction pathway downstream of DSIP binding has been definitively characterized

Additionally, ligands that are substrates of other BBB transport molecules such as P-glycoprotein, an efflux transport protein whose changes in expression are well-characterized with BBB breakdown in AD and neuroinflammation, similarly may demonstrate regional BBB degeneration in patients with AD (van Assema et al., 2012

This asymmetry should be a primary consideration for any researcher evaluating these compounds