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Decreased in serum vitamin C level due to consumed the vitamin during Non- Enzymatic anti-oxidant action due to highly reactive oxygen species generated due to chronic inflammation in patient with RA [36] the high disease activity means there is high inflammation responded in patient, this high respond lead to formation more ROS [37], it has been hypothesized that the variation in Se levels in RA patients is due to a redistribution of this mineral from the circulation to the tissues as a defensive mechanism against Inflammation 38, nevertheless, could result in selenoprotein turnover and Se depletion Similar to this, it has been proposed that the liver's production of antiinflammatory protein may inhibit the growth of SeP, the protein responsible for transporting selenium, leading to a reduction in the circulation of selenium

Antioxidant NAC was used to test if the cytotoxicity of the combined BSO and DPI treatment was mediated by a redox-related mechanism

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