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Elevated intracellular cAMP then drives the following cascade, as characterised in Mel-Ab and B16 melanocyte cell line preparations: MC1R cAMP PKA CREB phosphorylation MITF upregulation tyrosinase expression Picture it this way: MT1 docks at the extracellular binding pocket of MC1R, triggering a conformational shift that couples the receptor to the Gs protein

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We suggested to treat the patient with an alternative treatment