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The key mechanistic features: Gq/11 coupling activates phospholipase C- (PLC-) PLC- cleaves PIP2 generates IP3 and diacylglycerol (DAG) IP3 triggers Ca release from endoplasmic reticulum stores The calcium spike drives immediate GH vesicle exocytosis DAG activates PKC additional downstream signaling including ERK/MAPK Hexarelin's unusually strong GH response appears to involve additional mechanisms beyond standard GHSR-1a agonism

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high consumption of processed and refined food, with lack of dairy and meat-based food in diet, excessive consumption of alcohol, impaired absorption from the gastrointestinal tract or impaired storage and use by liver (1)

12 N- and C-terminal domains contribute to protein stability, subcellular localization, or proteinprotein interactions

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