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Benzyl alcohol, the preservative in bacteriostatic water, is contraindicated in neonates and premature infants due to the risk of gasping syndrome, as noted in BNF and MHRA guidance
It activates hormone-sensitive lipase and enhances -oxidation pathways in adipocytes and muscle cells
Exogenous MOTS-c supplementation may partially restore this responsiveness
It is critical for calcium and phosphate regulation, musculoskeletal health, immune modulation, and neurological function
Researchers should factor this into the study design
Other orthobiologics such as stem cell therapy or PRP, even newly developed cell editing drugs like Invossa for knee osteoarthritis have robust safety data in humans and ongoing randomized controlled trials to determine their efficacy
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