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However, it is disappointing that IGF-1 has not been shown to play a very significant role in promoting tendon healing in clinical trials, which could reflect our poor understanding of the molecular mechanisms by which IGF-1 is involved in promoting tendon regenerative healing

The functional consequence is pulse amplitude amplification: when an endogenous GHRH pulse fires, more GH is released per pulse

Journal of Biological Chemistry, 250(4), 1422-1426

Br J Sports Med 24, 253-64 (1990)

The peptide achieves this through multiple coordinated mechanisms including reduced inflammatory infiltration, enhanced collagen organization, and modulation of fibrogenic cytokine expression