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4 Hypothesis of the gut microbiota-ferroptosis axis in OA pathogenesis 4.1 Gut microbiota and abnormal iron metabolism synergistically promote joint ferroptosis 4.1.1 Gut microbiota promotes ferroptosis via hepcidin-FPN1 axis and FTN-mediated iron overload The gut microbiota modify systemic iron homeostasis through the modulating ability of microbiota to regulate the synthesis of hepatic hepcidin, an effect the subject of intense investigation