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Because semaglutide has strong albumin binding, which leads to prolonged receptor activation, it may disturb the rhythmic calcium and cAMP cross-talk essential for normal salivary secretion

The role of the ubiquitin proteasome system (UPS) in the heart The UPS as a central and highly selective proteostasis system in cardiomyocytes Alongside autophagy and mitophagy, the ubiquitinproteasome system (UPS) represents a central pillar of cardiac proteostasis, responsible for the highly selective degradation of damaged, misfolded, or regulatory proteins and thereby safeguarding cellular homeostasis and protein turnover (Fig

So again, these are not mutually exclusive, the direct route, the indirect route, but well take whatever we can get

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