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FOXO4-DRI acts as a competitive inhibitor of this interaction binding directly to the transactivation domain 2 (TAD2) of p53, displacing FOXO4, and allowing phosphorylated p53 to be exported from the nucleus and directed to mitochondria, where it activates BAX, triggers caspase-3 cleavage (via the p53/BCL-2/Caspase-3 signalling pathway), and drives cell-intrinsic apoptosis

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For OA patients with mechanical overload, correcting the abnormal mechanical environment while performing targeted molecular intervention is expected to more significantly slow cartilage degeneration (Zhang Y