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Conflicts of interest Both authors declare that there is no conflict of interest

These are pathway-level: they describe the metabolic terrain a clinician is prescribing into rather than predicting a specific response

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Proteolytic action of NSPs is controlled endogenously by the serpin (serine proteinase inhibitor) superfamily of proteins (e.g., alpha1-antitrypsin (AAT), alpha1antichymotrypsin, monocyte NE inhibitor) and the chelonianin family of canonical inhibitors (elafin, secretory leukocyte protease inhibitor) (82, 83)

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