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Endometriotic implants secrete estradiol (E2) as well as prostaglandin E2 (PGE2), agents that attract macrophages (monocyte chemotactic protein 1[MCP-1]), neurotrophic peptides (nerve growth factor [NGF]), enzymes for tissue remodeling (matrix metalloproteinases [MMPs]) and tissue inhibitors of MMPs (TIMPs), and proangiogenic substances such as vascular endothelial growth factor (VEGF) and interleukin-8 (6)

however, CS exposure reduces Nrf2 activity, leading to decreased expression of antioxidant genes and insufficient production of endogenous antioxidants

In the N-acetyl form, an acetyl group is added to the N-terminus of the four-residue chain, a modification commonly used in peptide chemistry to alter charge, lipophilicity, and resistance to aminopeptidase activity relative to the unmodified peptide