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12.2 Critical appraisal and future interventions However, despite the described clinical improvements, the current situation in clinical practice has some issues

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The peptide does not bind to growth hormone receptors in muscle tissue, does not stimulate protein synthesis or muscle hypertrophy, shows no effects on bone metabolism or growth, demonstrates no organ enlargement or proliferative effects, and avoids the connective tissue changes associated with growth hormone

These analyses also show that a significant number of cytokines (including IL1, IL1, TNF, IL2, IL12, IL18) and receptors (sIL-1RA, sIL-6R) are abnormally high in patients suffering from depression [98] and that these disturbances are present in the acute and stability phases, in MDD and BD [99]