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Although substantial weight loss can reduce pathological joint loading and systemic inflammation, the direct pharmacological effects on synovial fibroblastsattenuating their inflammatory signalling and fibrotic activation may offer an additional, disease-modifying and analgesic mechanism that targets the local synovial environment, driving pain and structural progression

Given the central role of SIRT1 in the metabolisminflammationimmune signaling axis, this review systematically examines its regulatory functions in MASLD initiation and progression

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N Engl J Med [Internet]

Importance of glutamine Glutamine is a rate-limiting factor in glutathione synthesis [9,10]