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Crucially, this study shifted the scientific paradigm from a simple model of "glutathione depletion" to a model of an "overwhelmed compensatory mechanism." The discovery that circulating immune cells in these patients actually have elevated glutathione levelswhile simultaneously suffering from a severe depletion of other protective enzymes like SOD2revealed that the cells are desperately, and unsuccessfully, trying to fight off a catastrophic level of oxidative damage

BMSC-Exos limit oxidative stress, inhibit cell death and ACSL4 expression, and prevent OA progression [175] (Table 1)

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