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This natural decline drives much of the research interest in supplementing exogenous GHK-Cu

Aside from age and genetics, another risk factor for spinal stenosis is lifestyle

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They promote the expression of catabolic enzymes (e.g., MMP-1, -2, -3, -13, and ADAMTS-4/5) and inhibit anabolic proteins like aggrecan and collagen II by activating signaling pathways such as NF-B, MAPK, and Toll-like receptors (TLR), ultimately leading to ECM degradation and tissue destruction (Lyu et al., 2021