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Once in circulation, Mn exists mainly as Mn 2+ bound to 2-macroglobulin and albumin, with small fractions bound to citrate or as transferrin-bound Mn 3+ (Roth J

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Hypoplastic Left Heart Syndrome (HHLS) occurs in about 1% of CHD and involves hypoplasia or atresia of the left sided structures including the LA, mitral valve, LV, aortic valve and ascending aorta (Figure)

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Unlike MT-1 whose linear backbone and tridecapeptide length confer preferential MC1R activity, MT-IIs cyclic heptapeptide structure produces a more compact, conformationally rigid pharmacophore with enhanced affinity at the centrally expressed MC3R and MC4R subtypes alongside maintained MC1R activity and generating the distinctive multi-system pharmacological profile that encompasses skin pigmentation through MC1R, pro-sexual and pro-erectile effects through hypothalamic and limbic MC3R/MC4R activation, and anorexia and energy balance modulation through hypothalamic MC3R/MC4R