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doi:10.1080/07853890.2021.1925955

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La prima reazione dello shuttle della carnitina un processo composto da due fasi, catalizzato da una famiglia di isoenzimi dell'acil-CoA sintetasi che si trovano nella membrana mitocondriale esterna, dove promuovono l'attivazione degli acidi grassi formando un legame tioestere tra il gruppo carbossilico dell'acido grasso e il gruppo tiolico del coenzima A per produrre un grasso acil-CoA

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