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This dual-pathway approach augments GH pulse amplitude through the GHRH axis while the ghrelin pathway contributes additional stimulatory drive, together producing amplified, physiologically representative GH secretion events

Why that selectivity exists at the receptor level isnt entirely settled it may reflect biased agonism, where the specific binding geometry favors the somatotroph signaling pathway over the corticotroph one, even though both cell populations express GHSR-1a

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