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This is a recurring hazard in neurodegeneration drug development, where surrogate measures are seductive precisely because clinical endpoints are slow, noisy, and expensive to move

Waldman, H

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In contrast, oral supplements must pass through the digestive tract, where factors such as stomach acid, enzyme activity, and gut health can affect the absorption rate

1 Engs paper, published in the Journal of Biological Chemistry , noted something strange: exendin-4 shared 53% of its amino acid sequence with a human gut hormone called glucagon-like peptide-1 (GLP-1), which had been characterized just a few years earlier