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Limited clinical validation: Despite decades of research interest, DSIP has not progressed into wide-scale clinical adoption, which raises questions about consistency and reproducibility of effects

Early synaptic dysfunction or synaptopathy at the level of inhibitory interneurons within the entorhinal cortex and CA3 hippocampal subregion leads to hyperactivity of pyramidal cells, which appears to play a role in the progression of AD neuropathology (e.g., tauopathy) (271, 272)

During this process, the co-synthetic product 2-acetyl-2-deacetyldoxycycline (impurity F) was simultaneously generated (27)