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In addition, the treatment of nicotinamide (NAM), a form of vitamin B3, suppressed the activity of sirtuin-1 (SIRT1), a regulator of cellular stress resistance, and peroxisome proliferator-activated receptor gamma coactivator-1 alpha (PGC-1), a key transcriptional coactivator involved in mitochondrial biogenesis and energy metabolism

Hence, we propose that l-carnitine may be considered an effective molecule to protect against synovitis in KOA