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This is partly a matter of evidence built up over many years, and partly practical, since metformins low cost means it is accessible to almost everyone regardless of insurance coverage

Recently, McDonald and colleagues revealed that frequent mistranslation events involving a shift from serine to either proline or arginine have distinct effects: serineto-proline substitution reduces the ability of polypeptide chains to bind HSP70s, whereas serineto-arginine substitution prevents misfolded nascent proteins from being denatured and degraded (McDonald et al., 2025)