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Ipamorelins pentapeptide structure , particularly the N-terminal Aib residue and D-2-Nal3 substitution , achieves high-affinity GHS-R1a binding and potent GH release while eliminating the receptor interactions at pituitary lactotrophs and corticotrophs responsible for prolactin and cortisol co-secretion in first-generation hexapeptide GH secretagogues, Selectivity and GH release potency are pharmacologically separable