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The clinical escalation protocol from the Phase 2 NEJM trial established a specific titration schedule that increases the dose every four weeks, starting low and building to a target maintenance dose
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10.5603/FM.a2020.0075 154 ZhangB.ZhengF.LiuA.LiZ.ZhengF.LiuQ.et al (2021)
Molecular pathways documented in preclinical research include: (1) activation of nitric oxide (NO) synthesis via L-arginine/eNOS pathway, (2) transcriptional upregulation of VEGF-A and FGF-2 favouring angiogenesis, (3) modulation of the Egr-1 early transcription factor involved in fibroblast proliferation, (4) interaction with 5-HT2A and dopaminergic receptors in some behavioural models, (5) stabilisation of endothelial function via eNOS modulation and reduction of oxidative stress (8-OH-dG, MDA)
