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The MITF (microphthalmia-associated transcription factor) pathway is simultaneously upregulated downstream of PKA/CREB activation, serving as the master transcriptional regulator that coordinates the entire melanogenic enzyme cascade, and this cAMP-PKA-CREB-MITF axis represents the canonical signaling pathway measured in Melanotan II potency assays

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[23] [24] Patients with a history of pancreatitis require careful risk-benefit discussion, though this is not an absolute contraindication