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The best approach to treatment is a multifaceted, individualized program incorporating first-line nondrug therapies such as exercise, education, and cognitive behavioral therapy, with the addition of drug therapies as needed

338 The accumulation of ROS further exacerbates cellular stress by inducing genotoxic damage, which can lead to overactivation of the p53 tumor suppressor gene, driving persistent senescence and amplifying inflammatory signaling through increased cytokine and metalloproteinase production, potentially accelerating the onset or progression of RA and other age-related inflammatory conditions

2023), enabling the possibility to simulate aggregate exposure in occupational contexts (Viegas et al

338 Therefore, inhibiting iNOS can reduce ROS production, suppress tumor growth, and modulate immune responses

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doi: 10.1111/ced.12515