This 2017 review specifically examined the beneficial effect of the Perna canaliculus (green lipped mussel extract) in regulation of the intestinal microbiome in addition to reviewing the immunomodulatory, cardiovascular, antimicrobial and antiarthritic effects. The review offers specific insights into mechanisms of action in each category. Green-lipped mussels may lead to prebiotic production as well as production of short chain fatty acids such as butyrate, both of which can indirectly also improve symptoms of osteoarthritis of the knee.
References:
Saltzman ET, Thomsen M, Hall S, Vitetta L. Perna canaliculus and the Intestinal Microbiome. Mar Drugs. 2017 Jun 30;15(7):207. doi: 10.3390/md15070207. PMID: 28665349; PMCID: PMC5532649. https://pubmed.ncbi.nlm.nih.gov/28665349/