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Briefly, when muscle is injured, overused, or mechanically stretched, satellite cells are activated to enter the cell cycle through a cascade of events including nitric oxide (NO) radical-dependent release of the active form of HGF (a hetero-dimer of - and -chains) from its extracellular tethering and the subsequent presentation of HGF to the cell-membrane signaling receptor c-met, followed by the sequence of steps including proliferation to produce myoblast progeny, differentiation, and fusion with existing muscle fibers and/or to form new fibers 18,19,20,21,22, 31

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PMID 20479765)

Zepbound is contraindicated in patients with a personal or family history of MTC or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN2)