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There are two 2HG enantiomers: D-2-hydroxyglutarate (D2HG) and L-2-hydroxyglutarate (L2HG), with the former predominantly generated from IDH1 mutants and PHGDH while L2HG is primarily generated from the promiscuous activity of LDHA and MDH1/2 under hypoxic or acidic conditions and converted back to 2OG by L2HGDH

However, the elevated levels of gGlu-Cys in artemisinin resistant parasites suggest increased activity of the glutathione synthesis pathway, likely driven by a post-translational mechanism

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Thus, UA can serve as a biomarker for indicating the risk and progression of PD, which should be used in combination with other biomarkers

We are thus cautious about the generalizability of these studies to greater populations

Winkler, E