In the long term, by stimulating GHRH neurons, GHS sustains its receptors by direct effect and also due to association with dopamine receptors to form GHSR1a:DRD2 heteromers 18
doi: 10.1104/pp.19.00916 164 VladF.SpanoT.VladD.DaherF
This has been correlated with the increased expression of transforming growth factor beta (TGF) and connective tissue growth factor (CTGF), which contribute to fibroblast proliferation, stimulation of collagen, and extracellular matrix synthesis [70], while purinergic receptor antagonists have been shown to have an effect on reducing these consequences [69], the proposed mechanisms include both the decrease in inflammatory biomarkers and oxidative stress [71]
Standardized dosing, biomarkers, and stratification by oral microbiome and endothelial NO synthase variants must be tested in large randomized controlled trials with cardiovascular outcomes
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