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In apoptosis, -sitosterol upregulates pro-apoptotic factors such as p53 and Bax, while downregulating anti-apoptotic proteins such as Bcl-2, leading to an increase in mitochondrial outer membrane permeability and the activation of key apoptotic enzyme cascades such as caspase-9 and 3, which induces programmed cell death (83)

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There is ongoing debate on the more effective method, with some preferring local injections for direct injury treatment, although systemic administration is also believed to be effective 3 4

Autophagy 8 , (2012)