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Cartilage destruction is considered a hallmark of OA and is a result of increased production of catabolic effectors 32,33,34,35 and reduced matrix biosynthesis by chondrocytes 36

For example, selenium-deficient animals and human cell lines exhibit reduced transcription of selenoproteins such as GPX1 , DIO s, SELENOI , and SELENOW 55,56,57

Because they enter systemic circulation, they can alter hormone levels, increase IGF-1 (which may raise cancer risk in certain cases), and cause unwanted metabolic effects

Nitric oxide and macrophage function

These observations suggest that the actions of DSIP on substance P, beta-endorphin, and corticosterone are indicative of a wider array of biochemical modifications, proposing that DSIP may trigger a cascade of molecular events that may facilitate its stress-modulatory functions