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The parallel with the enkephalin degradation pathway is notable given DSIPs apparent interaction with opioid peptide release

However, when GSK3 is inhibited by AKT phosphorylation the GAP activity of eIF2B remains high and consequently the rate of translational initiation by eIF2 remains high so protein synthesis is favored

Together these observations are consistent with an important concept: microglia are the earliest responders to a primary multifocal myelin injury in the MS white matter, and importantly, this injury/response seems to precede lymphocytic infiltration, arguing against adaptive immune cells being the primary drivers of white matter injury

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