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Furthermore, the label of chemically identical is often misleading, says Nitai Gelber, a Toronto-based sports medicine physician

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The most studied mechanisms include: upregulation of growth hormone receptors in fibroblasts (increasing sensitivity to healing signals), activation of the FAK-paxillin pathway (promoting cell adhesion and migration), modulation of the nitric oxide system through Src-Caveolin-1-eNOS phosphorylation (enhancing vascular function), and dual activation of the Egr-1/NAB2 gene loop (promoting organized, non-chaotic blood vessel growth)