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In addition, FOXO4-DRI has a relatively high production cost because of its long length and the requirement for D-type amino acids when synthesized (Table S1)

Recently, a human gene mutation of PAPP-A2, a circulating and tissue protease with IGFBP-5 (and to some extent IGFBP-3) as its primary substrate (Gaudamauskes et al), was demonstrated to have a marked growth phenotype involving fetal and post-natal growth retardation in children in a consanguineous family (43)

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