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This bidirectional regulatory process involves multiple interrelated mechanisms, including dysregulation of local prolactin synthesis and secretion (e.g., originating from adipose tissue or other extrapituitary tissues), alterations in prolactin metabolism and clearance processes, and a persistent chronic low-grade inflammatory state ( Figure 2 )

Interestingly, obestatin did not inhibit the stimulatory effect of ghrelin on ACTH release (119)

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Front Pharmacol 2022;13:765446.ArticlePubMedPMC 86