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Future studies are still needed to further clarify the causal relationships of amino acid metabolism in autoimmune diseases and its hierarchical position in immune regulation through more systematic genetic studies, metabolic flux analyses, and single-cell multi-omics approaches, so as to distinguish its specific role as a disease driver or as a passenger/metabolic marker

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These accumulated nephrotoxic moieties demonstrate remarkable capacity to traverse formidable biological barriers including the bloodbrain and blood-pancreatic barriers, orchestrating deleterious multi-organ system perturbations encompassing the central nervous system, pancreas, and skeletal musculature through sophisticated epigenetic modifications and pivotal signaling pathway dysregulation, ultimately catalyzing systemic endotoxemia characterized by relentless low-grade inflammatory cascades and profound immunological dysregulation, establishing a pernicious pathophysiological vortex that exponentially accelerates renal functional deterioration (Bossola and Picconi, 2024