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Moreover, it has been shown that stomach cancer is more likely to develop as a result of the oxidative stress brought on by CagA-positive bacteria (74), in which H pylori CagA produces cells with oxidative DNA damage by inducing spermine oxidase (SMO), and a portion of these cells are apoptosis-resistant and therefore highly susceptible to developing cancer (75)

The combination of these two optimized structures offers several practical advantages over native hormone combinations: enhanced intrinsic potency means lower doses may be required to achieve equivalent effects, improved proteolytic stability extends duration of action compared to native peptides, preserved selectivity avoids unwanted endocrine effects, and the complementary optimization strategies (helix stabilization for GHRH, selective receptor activation for GHRP) address different aspects of the synergistic interaction

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