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The mechanism of action isnt well understood, but its believed it doesnt affect the tendon tissue cells directly, but rather that either works by activating other repair cells that can help tendons or ligaments or making the human growth factor receptor on the repair cells more sensitive (3)

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Although they are less stable and have weaker binding affinity for nucleic acids, their biocompatibility makes them more suitable for transdermal rather than gene delivery applications (Gonzlez-Rodrguez and Rabasco 2011)

And, as always around here, they all start by addressing the root causes