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Regarding the mechanisms of crossing the nasopharyngeal barrier, a combination of transcellular and paracellular pathways seems possible if meningococci using the transcellular pathway induce a sufficient level of inflammation to alter epithelial permeability, allowing other meningococci to follow the paracellular pathway

The current evidence is promising but incomplete

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References Wikipedia Modified GRF (129): structure, amino acid substitutions, and pharmacokinetics Journal of Clinical Endocrinology & Metabolism (2006) Teichman et al.: Prolonged stimulation of GH and IGFI by CJC-1295 in healthy adults American Journal of Physiology (2006) Alba et al.: Oncedaily CJC-1295 normalizes growth in GHRH knockout mice Journal of Clinical Endocrinology & Metabolism (2006) Veldhuis et al.: Pulsatile GH secretion persists during continuous CJC-1295 stimulation PMC Growth Hormone Secretagogue Treatment in Hypogonadal Men Raises Serum IGF1 Levels PMC Effects of GHRH Analog (Tesamorelin) on Endogenous GH Pulsatility and Insulin Sensitivity PMC Sermorelin: a better approach to management of adultonset growth hormone insufficiency PMC Beyond the androgen receptor: role of GHS in body composition in hypogonadal males PMC The Safety and Efficacy of Growth Hormone Secretagogues (Review) PMC GHRH Effects on Brain GABA Levels in Mild Cognitive Impairment and Healthy Aging PubMed Sermorelin: review of its use in diagnosis and treatment of GH deficiency CDC Vaccine administration: subcutaneous route (angle/site

Saudi J Gastroenterol (2016) 22:3