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The peptide incorporates specific amino acid substitutions that make it resistant to dipeptidyl peptidase-4 (DPP-4), the enzyme primarily responsible for degrading natural GHRH

It works by attaching to IGF-1 receptors on cells, which then activate key internal cell pathways, including PI3K-Akt and MAPK

NMDA receptor signaling promotes various responses such as excitation, neurotrophic function, and can even activate cell death pathways

3.3 Oxidative stress and calcium overload Oxidative stress and calcium overload are tightly interconnected mechanisms of mitochondrial dysfunction in HF