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There are six IGFBPs types (containing approximately 200–300 AAs) that regulate IGF signaling and prolong its half-life, and they bind more than 90% of IGF-1 present in circulation (about 1% of IGF-1 in circulation are in a free-active form), simultaneously blocking its binding to IR (42, 43)
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This highlights that targeting the epigenetic writers of metabolic stress (including histone lactylation domains) can yield potent clinical outcomes when used in rational combinations
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