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The synthesis and recycling of tetrahydrobiopterin (BH4) is a dynamic process, and GTP cyclohydrolase-1 (GCH1) is the rate-limiting enzyme in the biosynthesis of BH4
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The cycle structure exists for a practical reason: continuous stimulation of the same receptor pathways can lead to reduced sensitivity over time, and a rest period allows the system to reset before the next cycle produces full effect
Providing detailed evidence of these practices can prompt investigations and potential enforcement actions
Cooper calls penny-wise and pound-foolish given the downstream costs of diabetes and cardiovascular disease
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