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Through inflammatory cell infiltration (neutrophils, T/B cells), cytokine network imbalance, and vascular wall structural destruction, it ultimately leads to vascular stenosis, occlusion, or rupture, resulting in tissue and organ ischemia or hemorrhage (210, 211)

Alberti A, Pirrone P, Elia M, Waring RH, Romano C

There also have been sporadic warning letters (like this one from December 2025) citing the unlawful distribution of unapproved GLP-1 agonists, such as retatrutide, to compounders

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