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These findings demonstrate the important relationship between the processes of methylation, Hcy formation and GSH formation

Taken together, these findings suggest that Nrf2 plays a vital role in mediating the chondroprotective effects of metformin by means of anti-oxidation, and that loss of Nrf2 substantially attenuates, but does not completely abolish, the therapeutic efficacy of metformin in the MIA-induced OA model

The effect is largely owing to higher levels of DNA repair endonuclease XPF and DNA excision repair protein ERCC1, which are important components in the NER pathway