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Further studies will be required to investigate sensitivity to change with disease progression, and assess potential impact on clinical trial design

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This occurs via a series of similar steps: Acyl-CoA is conjugated to carnitine by carnitine acyltransferase I (palmitoyltransferase) located on the outer mitochondrial membrane Acyl-carnitine is shuttled inside by a carnitine-acylcarnitine translocase Acyl-carnitine is converted to acyl-CoA by carnitine acyltransferase II (palmitoyltransferase) located on the inner mitochondrial membrane