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The transcriptional mechanism involves activation of the TGF-β/Smad signaling cassette: GHK-Cu promotes the phosphorylation and nuclear translocation of Smad2 and Smad3, their heterodimerization with Smad4, and subsequent binding to Smad-binding elements in target gene promoters

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These include the presence of gross irregular scarring, inflammation, fibrosis and deformity of calyces underlying parenchymal scars, predominant tubulointerstitial histological damage, and relative lack of glomeruli