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L-carnitine decreases severity and type of fatigue induced by interferon-alpha in the treatment of patients with hepatitis C
The rate-limiting step in this process is the carnitine shuttle, specifically the CPT-I enzyme that attaches carnitine to long-chain fatty acids so they can cross the inner mitochondrial membrane
Once the substrate is appropriately positioned, the activated serine nucleophile of the catalytic triad (Ser630) can attack the peptide bond between the second and third residue, and form a tetrahedral covalent intermediate
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