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Similarly, NF-κB—activated by ROS and inflammatory cytokines (e.g., IL-1β)—upregulates pro-apoptotic factors, cuproptosis/ferroptosis drivers (e.g., ATP7B, GLS), and inflammatory mediators while suppressing cytoprotective autophagy, thereby amplifying cartilage destruction (Shen et al., 2025) (Figure 5)

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This finding suggests that an increased dietary supply of methyl groups in the form of choline or betaine may increase Met catabolism by transmethylation and transsulfuration