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Description
First, acetyl-CoA in mitochondria is condensed with oxaloacetate, catalyzed by citrate synthase, to form citric acid, which is then transported to the cytosol by tricarboxylic acid transport proteins in the mitochondrial membrane
This rapid accumulation of lactic acid and the resulting drop in cellular pH is a primary driver of post-exertional malaise (PEM), the hallmark symptom of ME/CFS and Long COVID
Van Wouwe JP
Neuron 93 , 12961313 (2017)
Occurs when the antioxidant capacity of cells is depleted, resulting in the generation of oxidants such peroxynitrite and superoxide radicals (ROS-like)
