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PEM, also called Post-Effort Symptom Exacerbation (PESE) (265), can be best evidenced and provoked by two CardioPulmonary Exercise Test (CPET) 24 hours apart

Plasma GHK levels decline with age (from ~200 ng/mL in young adults to ~80 ng/mL by age 60), making it a heavily studied compound in dermal biology, fibroblast research, and tissue remodeling literature

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