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Many of the immune modulating effects of Se are due to its role in regulating activation of important transcription factors including NF-B (38, 39), p38 MAPK (39), ERK (40), JNK (41) and AP-1, at least in part, by modulating redox status (42)

Oxidative stress is a prominent physiological feature of ALS, and mechanisms responsible for reducing oxidative stress are compromised 22

[1] [2] It is marketed under the brand names Mounjaro (for diabetes) and Zepbound (for weight management in adults with obesity [BMI 30 kg/m] or overweight [BMI 27 kg/m] with at least one weight-related comorbid condition)

Acknowledgements We express our appreciation to Gerhard van der Horst and Liana Maree for their assistance with the Computer Assisted Sperm Analysis equipment

Intraurethral alprostadil (a small pellet inserted into the urethra) and topical alprostadil cream are alternatives for those who prefer not to inject