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Nrf2, involved in osteoclastogenesis, PGs secretion and ROS production (62, 116), is very important for regulating oxidative stress, inflammation, immune response and cartilage and bone metabolism (217), and serves as an important target for inflammatory disturbance and oxidative stress in RA

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Notably, gut microbiota, a major determinant of bidirectional communication between the gut and brain, could be regulated by a number of mechanisms, and it is illustrated that the microbiota and its produced biochemical messengers are major facets of maintaining a balanced intestinal microenvironment

L-carnitine helps alleviate muscle injury and reduces markers of cellular damage and free radical formation that can cause muscle soreness and inflammation