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The mediators that drive the accumulation of these cells and of the matrix are incompletely defined, but it is likely that several mediators including TGF-, ET-1, Insulin-like growth factor-1, fibronectin, platelet-derived growth factor (PDGF), and others are involved 89

Binding of GH to a growth hormone receptor (GHR) homodimer induces autophosphorylation of JAK2

In addition, after oxidative damage occurs in the kidney, AS-IV administration can regulate the Nrf2/heme oxygenase-1 (HO-1) pathway to strengthen the expression of pNrf2 and HO-1 further and maintain high Nrf2 activity

While this adaptation supports oxygen delivery in hypoxic environments, sustained elevations in hemoglobin can increase blood viscosity and cardiovascular risk, particularly in older adults

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