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Furthermore, the lactate metabolizing enzyme LDHB promotes H3K18 histone lactoylation, enhances ACSL4 expression, and induces chondrocyte ferroptosis, representing another epigenetic regulatory target for OA (171)

The most extensively documented mechanism involves upregulation of vascular endothelial growth factor, known as VEGF, and the broader angiogenic program

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In addition, those who have COMT Val/Val genotype (genotype with greater enzyme expression) were associated with a significantly increased risk of UF as compared to those with Val/Met genotype (intermediate expression) and Met/Met genotype (low expression), which could have explained the higher risk of UF in African American women (47% having Val/Val genotype) ( In vitro study showed that the ability of green tea extract in inhibiting the proliferation of leiomyoma cells is in part due to the potential of EGCG in reducing the expression of the COMT enzyme (Zhang et al., 2014)