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The pathway starts with epoxidation of fumaric acid to the warhead (2 S ,3 S )- trans -epoxysuccinic acid with an Fe(II)/-ketoglutarate-dependent oxygenase, followed by successive condensation with an l-amino acid by an adenosine triphosphate grasp enzyme and with an amine by the fungal example of amide bond synthetase
Limited human case series data suggests variable treatment durations
[14] [19] Some patients experience complete resolution of nausea relatively quickly, while others may have intermittent mild symptoms that persist longer
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