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5 Briefly, the conversion of dietary precursors into TMA involves four enzymatic pathways, including the choline-utilizing TMA lyase system (CutC/D), the carnitine Rieske-type oxygenase/reductase system (CntA/B), betaine reductase, and TMAO reductase

These aggregated substances may increase the risk of formulation instability and potential sensitization

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