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Subsequent studies from other groups have confirmed our original findings.65 Pleiotropic effects involving distinctive receptors, including VEGFR2 and growth hormone receptors, distinctive pathways, including VEGFR2-AKT-eNOS, ERK , FAK-paxillin, FoxO3a, p-AKT, p-mTOR and p-GSK-3, and distinctive loops, including stimulation of the egr-1 gene and its corepressor gene naB2, and counteraction of increases in pro-inflammatory and procachectic cytokines, likely minimize the inherent lack of full understanding of the mechanisms that may be involved

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This combination improved the effectiveness of carnitine in a way that carnitine alone never achieved