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The glutamate residue is linked through its side-chain carboxyl, giving a gamma-glutamyl bond rather than a standard alpha-peptide bond, which is why the molecule resists most intracellular peptidases and is cleaved chiefly by gamma-glutamyl transpeptidase at the cell surface

[62] reported limited improvements in sperm presence and no significant change in FSH levels, underscoring the need for further research to clarify the specific effects of PRP across different NOA subtypes and to identify predictive factors for treatment response

In addition, risk ratios (RR) were used to express the pooled effects of GLP-1 receptor agonists vs

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