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Mol Endocrinol 9(2):243254 Lee SY, Pearce EN (2023) Hyperthyroidism: a review
DOI: 10.1080/10715762.2018.1447670 [26] Ma Y, Gao M, Liu D
The identified proteases responsible for its rapid decay are DPP-4 (dipeptidyl peptidase-4) 34 , which cleaves selectively between residues 2 and 3, and NEP 24.11 35 , which cleaves at multiple sites
This means more snacking, more frequency, and more indulgence
Key mechanistic features: Selective GHSR-1a agonism Potent GH release without cortisol/ACTH/prolactin elevation Gq/11 Ca signalling Intracellular calcium rise triggers GH exocytosis Pulsatile GH release Preserves physiological GH pulse pattern
Interestingly, the obese MCAS patients tolerated the high dose quite well, while others did fine on lower doses
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