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Bridging this translational gap will require rigorous clinical validation, improved delivery strategies, and careful regulatory frameworks to ensure safe and effective integration of peptide therapeutics into musculoskeletal medicine

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It helps neutralize free radicals and maintains cellular redox balance

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The mechanism works as follows: Ergothioneine binds to MPST with high affinity (Kd of 3.2 M) MPST activation increases HS production HS causes persulfidation of glycerol-3-phosphate dehydrogenase (GPDH) Persulfidated GPDH shows enhanced activity for NAD+ regeneration Elevated NAD+ supports muscle vascularization and stem cell health In middle-aged rats, three weeks of ergothioneine supplementation (20 mg/kg) nearly doubled exercise endurance and running distance while increasing muscle mass and NAD+ levels [5]