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Research suggests it may work through different mechanisms, potentially involving direct interaction with adipocyte membranes or intracellular signaling pathways distinct from classical GH receptor activation

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18, 19 According to William Morton, who has written extensively on porphyrias, MCSS as first described by Cullen in 1979 may, in fact, be porphyria

Additionally, the RNA editing enzyme ADAR1, the nucleic acid repair exonuclease TREX1, and the interferon-induced nuclear protein IFI-16 are activated to ensure DNA repair and prevent abnormal activation of interferons (116118)

Factors affecting the timeline include dosage, frequency, and delivery method

Hassabo HM, Hassan M, George B, Wen S, Baladandayuthapani V, Kopetz S , Fogelman DR, Kee BK, Eng C, Garrett CR