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For instance, in M1 pro-inflammatory macrophages (Ms), there is a metabolic break at isocitrate dehydrogenase in the TCA cycle due to suppression of its mRNA expression, leading to the accumulation of citrate and itaconate, which drive lipid synthesis and stabilization of anti-inflammatory transcription factors, such as nuclear factor-erythroid factor 2-related factor 2 (NRF2) and activating transcription factor 3 (15)

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By targeting visceral fat rather than subcutaneous fat, Tesamorelin addresses a key factor in poor metabolic health

PMID 17959839