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This extraordinary potency arises from the combination of the D-phenylalanine substitution at position 7, which confers enzymatic resistance and enhanced receptor binding geometry, the Nle substitution at position 4 that prevents methionine oxidation, and the cyclic lactam constraint that pre-organizes the pharmacophore into the bioactive conformation
Human metabolism is influenced by a broader array of genetic, environmental, and dietary factors, which may modulate the clinical manifestations of similar genetic variants