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GHRH upregulates the pituitary-specific POU homeodomain transcription factor, Pit-1, which in turn, transcriptionally upregulates the GH1 , GHRHR and Pit-1 genes (auto-upregulation)

These defects, compounded by impaired signaling and substrate availability as well as dysregulated transcriptional control, collectively establish a vulnerable metabolic foundation predisposing the brain to neurodegeneration (Ryu et al., 2021)

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