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Major barriers to the clinical use of gene therapy, however, include transfection efficiency, the creation of long-term effects, the difficulty of controlling cell proliferation, ectopic transfection, disease transmission, patient-specific dose responses, immune reactions against viral proteins, possible side effects, and ethical issues [87, 88]

Upon entering the cell via monocarboxylate transporters, T3-receptor complexes translocate to thyroid hormone response elements on chromatin, recruiting co-activator proteins and modulating transcription of genes involved in oxidative metabolism, mitochondrial biogenesis, -adrenergic receptor density, and lipid-carbohydrate homeostasis

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It has been detected in central nervous system tissues, peripheral organs, and various biological fluids across multiple animal models, although its biosynthetic origin and precursor structure remain incompletely characterised