MSRA and hypophosphatasia: The ALPL gene encodes tissue-nonspecific alkaline phosphatase, whose dysfunction leads to hypophosphatasia, a hereditary disorder characterised by impaired skeletal mineralisation and muscle weakness.54 The MSRA gene encodes methionine sulfoxide reductase A, crucial for protein repair and combating oxidative stress,46 which is a significant driver of ageing and muscle dysfunction.22 These findings suggest that skeletal integrity and protein homeostasis may play roles in the pathogenesis of oral frailty.