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During exosome formation, MSU crystal-stimulated neutrophils promote the synthesis of LTB4: cytosolic phospholipase A2 alpha translocates to the nuclear membrane, where it releases AA from membrane-bound phospholipids, whereas 5-lipoxygenase (5-LOX) is mobilized to the nuclear membrane, where it binds to 5-LOX-activating protein (FLAP) and acts on AA to produce leukotriene A4 (LTA4)

Estrogen has been shown to impact collagen synthesis and wound healing, suggesting that hormonal regulation may play a role in the rehabilitation of ACL injuries

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The appropriate response to that uncertainty is not to abandon the compound but to use it within a structured clinical framework: defined goals, evidence-appropriate dosing, quality-assured sources, systematic monitoring, and ongoing reassessment as the science matures