Fig. 6: Spermidine inhibit the ubiquitination of RIP1 in TNF-α driven NF-κB/p65 inflammation pathway in Fibroblast synoviocytes (FLS) of osteoarthritis (OA).

The RIP1 ubiquitination that inhibited by spermidine resulting in the decreased phosphorylation of the IKK complex including the most important p65 transcription pathways. Afterward, the inflammatory cytokines such as IL-6, IL-8 and TNF-a, were decreasingly secreted by FLS. The decreased infiltration of inflammatory cytokines on cartilage, which ameliorate the degenerative expression of chondrocytes including Aggrecan, Collagen10, ADAMTS4, ADAMTS5, MMP3 and MMP13, and finally alleviate the progression of OA.