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In the setting of chronic inflammatory disease states (e.g., Crohn’s disease or juvenile chronic arthritis), these diseases can also disturb the physiological synergy of the GH/IGF-I axis
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The currently known retrograde signaling is mainly activated by OXPHOS and mitochondrial DNA defects, which activate AMPK (AMP-activated protein kinase) or NF-κB (Nuclear factor-κB) pathways to alter gene expression in the nucleus through mediators such as ROS, calcium ion concentration and ATP content [35]
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