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This does not eliminate TMAO production entirely, as some circulating levocarnitine can be excreted into the gut, but it likely reduces the total TMAO burden compared to equivalent oral doses

Activation of the HIF-1 pathway in SDH-deficient tumors is most likely the result of accumulating levels of succinate which is then transported into the cytosol via the action of the mitochondrial dicarboxylate transporter

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