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In patients with idiopathic PAH, the expression of PD-1/PD-L1 on the surface of peripheral blood CD4 + and CD8 + lymphocytes are significantly upregulated, the proportion of Tregs is increased, and IL-10 secretion is reduced, suggesting that excessive activation of the PD-1/PD-L1 axis synergizes with Treg dysfunction to exacerbate immune dysregulation and affect metabolic homeostasis (Tomaszewski et al., 2024)

found that when GHRH was administered in a pulsatile fashion during the first half of the night, it significantly increased both GH levels and slow-wave sleep in healthy young men

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