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Severe sarcopenia can also lead to impaired physical function, reduced activities of daily living, decreased exercise tolerance, and balance disorders, which increase the risk of fractures by 23 times (32, 3537)

Moreover, ROS induced by copper and iron can cause DNA double-strand breaks, cell cycle arrest, mitochondrial dysfunction, lipid peroxidation and protein modification, which may ultimately mediate diverse types of cell death [29,30,31] (Table 1)

32 Efflux lowers the intracellular drug concentration below inhibitory levels

KIR3DL1 interaction with HLA-B27 is altered by ankylosing spondylitis associated ERAP1 and enhanced by MHC class I cross-linking