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Catabolic states Clinical investigators have shown that IGF-I levels are often significantly altered in catabolic states, including the acute postoperative period[367], burn patients[368] and chronic catabolic illnesses, such as cystic fibrosis[369] and HIV with wasting[370]

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Notably, the tryptophan residue W248 6.48 acts as a toggle switch in this activation process, connecting the rearrangements initiated by the chemokine N-terminus to the large-scale relocation of TM6 and TM7 107