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Moreover, GLP-1R activates adenylyl cyclase (AC) to produce cyclic adenosine monophosphate (cAMP), which in turn activates protein kinase A (PKA) that activates cAMP response element-binding protein (CREB), a constitutively expressed nuclear transcription factor that regulates the expression of genes involved in inflammation [11, 12]

This represents a significant limitation in the evidence base, as large-scale human trials examining musculoskeletal applications have not been published

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