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The peptide influences both endothelial nitric oxide synthase (eNOS), which produces the beneficial, vasodilating form of nitric oxide, and inducible nitric oxide synthase (iNOS), which can produce excessive amounts that contribute to inflammation and tissue damage

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Additionally, chemokines such as MCP-1, MIP-1, MIP-3a, RANTES, IL-8, SDF-1, and fractalkine play important roles in the progression of TMJ disease by promoting the chemotactic activity of inflammatory cells, leading to the destruction of structures such as the synovium, cartilage, and bone (52)