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In the United States , IGF-1 is a controlled substance and is banned by most professional sporting bodies, including the World Anti-Doping Agency (WADA) , where it appears on the Prohibited List under peptide hormones and growth factors

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The substitution of D-alanine at position 2 reduces susceptibility to enzymatic cleavage

Future studies utilizing spatial transcriptomics or single-cell nucleus RNA sequencing will be critical to determine whether these inflammatory patterns persist at the regional and cellular levels