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GHK-Cu is believed to function as a signaling peptide, meaning it helps support normal communication between cells involved in maintaining healthy skin

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Rather than engaging a single high-affinity receptor, the pentadecapeptide modulates multiple intersecting cellular pathways including nitric oxide system signalling, growth-factor receptor expression (notably VEGF receptor 2 and growth-hormone receptor), dopamine and serotonin pathway markers, and angiogenic factor regulation

Also, to assess the AES symptoms, items from a previously established questionnaire available in the cohort were utilized, following theoretical models and earlier research findings