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However, the ability of colistin to penetrate the lungs is limited

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The elevation in cAMP also stimulates protein kinase A which phosphorylates and activates the transcription factor CREB (cAMP response element binding protein), which then stimulates de novo GH production via transcription of the GH1 gene as well as increasing transcription of the GHRH receptor gene as part of a short positive feedback loop To summarize all of this in one sentence GHRH is responsible for both the production and secretion of growth hormone

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