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The mechanism is genuinely interesting and multi-pathway, but several steps remain incompletely characterized: Growth hormone receptor pathway: Animal studies from the Sikiric group show BPC-157 upregulates GH receptor expression in tendon fibroblasts, which may amplify local anabolic signaling without raising systemic GH or IGF-1 levels

The authors reported concentration-dependent increases in dry weight, total protein, collagen, and glycosaminoglycan content in harvested cylinders

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