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R The product PAP (3'-phosphoadenosine-5'-phosphate) is a competitive inhibitor of SULTs that must be degraded by PAP phosphatase to prevent feedback inhibition
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Its mechanism can be summarized as: Activation of the GHRH receptor cAMP/PKA signaling inside pituitary somatotrophs Endogenous growth hormone synthesis and release Downstream IGF-1 and IGFBP-3 elevation GH-dependent signaling in peripheral tissues Structural stabilization through its N-terminal modification Importantly, tesamorelin is not growth hormone
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