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Although Pioglitazone was initially thought to act only as a direct transcriptional regulation of the PPARγ nuclear receptor, later data revealed that it also binds to mitochondrial membranes ( Studies conducted in multiple cell types demonstrated that TZDs inhibit mitochondrial pyruvate carrier (MPC) activity by direct binding (Buchanan and Taylor, 2020), which may mediate some of the beneficial effects of PGZ a variety of diseases including vitiligo