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Bilirubin is a breakdown product of heme, that non-protein part of hemoglobin)

(PubMed) Bosch AM, Abeling NG, Ijlst L, et al

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The primary mechanism of action involves the activation of telomerase, an enzyme responsible for maintaining and extending telomeresthe protective caps at the ends of chromosomes

For instance, an in vivo study in RA models used poly(lactic-co-glycolic acid)poly(ethylene glycol)-maleimide (PLGA-PEG-MAL) NPs conjugated with joint-relevant peptide antigens (aggrecan 70-84 and type II bovine collagen 256-270 ) and encapsulating calcitriol [152]

The copper ion serves as an essential cofactor for enzymes involved in extracellular matrix maintenance including lysyl oxidase and superoxide dismutase