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The aforementioned outcomes are accomplished through a range of mechanisms, including upregulating the expression of endothelial nitric oxide synthase (eNOS), enhancing the phosphorylation of eNOS at Ser1177, downregulating the expression of NADPH oxidase (NOX), increasing the levels of tetrahydrobiopterin (BH4) in the vasculature through GCH1-dependent pathways, and restoring the coupling of eNOS to facilitate the availability of NO (105)

Decision framework for compromised peptides Definitely discard if: visible precipitation, significant color change, unusual odor, reconstituted solution left at room temperature more than 4 hours, or lyophilized peptide at warm temperature for more than 2 weeks

This can be combined with an IV drip of nutrients or on its own as an IV push

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The maintenance phase sustains healing at lower, less frequent doses