In normal physiology, the majority of circulating IGF-1 is bound to IGFBP-3, forming a large ternary complex with the acid-labile subunit that prevents rapid clearance and buffers free IGF-1 within a tightly controlled range
NSAIDs cause topical mucosal damage by inhibiting COX-1, resulting in a decreased level of prostaglandins, which protect the gastric mucosa, and thereby resulting in damage in both the upper and lower gastrointestinal tracts (GITs) [12]
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doi: 10.3389/fmed.2022.896263 49