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The authors concluded that GHK acts by affecting TGF-1/Smad 2/3 and IGF-1 pathway

When proliferating chondrocytes mature, they increase the production of Ihh, which acts on its receptor Patched in the neighboring cells via unknown mechanisms to increase the production of PTHrP (39), thus slowing down cell differentiation to prevent early closure of the growth plate (Figure 1)

6. :

Chewcharat A, Chewcharat P, Liu W, Cellini J, Phipps EA, Melendez Young JA et al (2022) The effect of levocarnitine supplementation on dialysis-related hypotension: a systematic review, meta-analysis, and trial sequential analysis