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doi: 10.1152/ajpheart.00146.2010 41 MilanGRomanelloVPescatoreFArmaniAPaikJHFrassonLet al

Smith TJ (2010) Insulin-like growth factor-I regulation of immune function: a potential therapeutic target in autoimmune diseases

While Tesamorelin acts on GHRH receptors to stimulate growth hormone release, Ipamorelin acts through the ghrelin receptor pathway instead a separate mechanism that researchers sometimes examine alongside the other three compounds in the same body of literature, though again as a conceptual comparison rather than a combination protocol