In our opinion, the well-note PsA comorbidities could have a minor impact on BCAAs unbalance (not all patients develop metabolic syndrome), with a greater effect of arthritis as the primary symptom of our cohort: we can suppose that reported results are inflammation-driven, and the activated catabolism associated with this condition, contributes to the decreased BCAAs circulating levels, maybe because an higher uptake of these amino acids to fuel the immune response and cellular metabolism
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Theres no regulation requiring proof