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Description
This effect is likely due to a requirement for IL-21 produced by CD4 T cells to promote generation of the Texh-int subset which contains more functional cells within the exhausted hierarchy 63

Natural growth hormone secretion follows complex circadian and ultradian rhythms characterized by distinct pulses occurring approximately every 3-4 hours, with the largest pulses typically occurring during deep sleep phases

10.1124/jpet.105.097733 229 TokuyamaS.FengY.WakabayashiH.HoI

J Am Soc Nephrol 10: 13031308, 1999
