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"Triple-Hormone-Receptor Agonist Retatrutide for Obesity, A Phase 2 Trial." New England Journal of Medicine , 2023

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This, in turn, stimulates downstream signaling elements dependent on both protein kinase A (PKA) and exchange protein directly activated by cAMP (EPAC) activation, which triggers the opening of voltage-dependent calcium channels (VDCCs), resulting in insulin exocytosis [24, 25]

[25] Tretinoin, the all-trans retinoic acid isomer, diffuses through the stratum corneum and binds intracellular retinoic acid receptors (RAR-, , ), forming heterodimers with RXR that trans-activate genes governing keratinocyte differentiation, desmosomal degradation, and collagen synthesis