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Ethics declarations Competing interests PCh and PCl have received research support and honoraria as speakers and consultants from Merck Serono

Larazotide is studied for tight-junction integrity (the leaky-gut pathway), and KPV is an anti-inflammatory peptide derived from alpha-MSH

Rapid injection can cause discomfort and may disperse the peptide unevenly

Pyroptosis can be identified by a combination of specific markers, which include TLR4, GSDMD, activation and release of pro-inflammatory IL-1 and IL-18, as well as the activation of cysteinyl aspartate specific proteinases, such as caspase-1, caspase-3, caspase-4, caspase-5, and caspase-11 (125)

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What is documented about the two peptides comes overwhelmingly from animal studies, in which they have generally been well tolerated at the doses tested