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The product of the ACMSD reaction goes on to be further metabolized to acetoacetyl-CoA, the ultimate end product of complete tryptophan catabolism

This explains their clinical impression completely

Michael Gold, a Nashville dermatologic surgeon, in this RealSelf Q&A
A comparative analysis of reactive Muller glia gene expression after light damage and microRNA-depleted Muller glia-focus on microRNAs
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