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The structural modifications incorporated into CJC-1295 include D-alanine at position 2 to enhance resistance to enzymatic degradation, glutamine at position 8 to reduce asparagine rearrangement and prevent amide hydrolysis to aspartic acid, alanine at position 15 to enhance bioactivity, and leucine at position 27 to prevent methionine oxidation

A significant influx of undigested proteins into the distal intestine as a result of impaired protein absorption encourages the overgrowth of proteolytic bacteria (Sorensen, 1965), which in turn causes an increase in protein fermentation clinically manifesting in protein-energy wasting, cardiovascular diseases, neurological syndromes, and CKD progression (Figure 3)

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