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Shoemaker's research demonstrated that patients with CIRS consistently show severe abnormalities in inflammatory blood markers, including highly elevated TGF-beta1, C4a, and MMP-9, alongside drastically depleted levels of Melanocyte Stimulating Hormone (MSH) and Vasoactive Intestinal Polypeptide (VIP)

doi: 10.1016/j.celrep.2013.05.009 133 SChadtLSparanoCSchweigerNASilinaKCecconiVLucchiariGet al

These changes are also related to improvements in quality of life, as they can alleviate common symptoms such as fatigue, jaundice, and gastrointestinal discomfort in patients with advanced liver disease [44]

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