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The [M + 4 H] 4+ ion at m/z 1204.3, corresponding to tetra-protonated tirzepatide (calculated m/z = 1204.14), exhibited the highest response and was selected as the precursor ion for MRM

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Mechanistically, GLP-1R activation raises cAMP levels and triggers the PKA/CREB (cAMP-response element-binding protein) signal transduction pathway, which regulates various cellular processes [111]

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