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a melanocortin receptor "agonist is meant an endogenous or drug substance or compound, including a compound such as PT-141, which can interact with a melanocortin receptor and initiate a pharmacological response, including but not limited to adenyl cyclase expression, characteristic of the melanocortin receptor

The action on kidneys appears to be directly through the effects also on renin-secreting cells of the juxta-glomerular apparatus, whose stimulation may lead to increased natriuresis and reduce hyperfiltration, and indirectly by the reduction of angiotensin II levels, the increase in nitric oxide with consequently endothelial vasodilation and the improvement of risk factors of kidney disease (hyperglycemia, hypertension, obesity) ( Figure 2 )

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The altered autoregulation of blood flow cannot meet the metabolic demand of tissues in ME/CFS, leading to tissue hypoxia and subsequent ischaemia/reperfusion injury with its associated symptoms and signs ( Endothelial damage Endothelial cells are important regulators of the immune system (308)