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In turn, the impairment in -oxidation can shift the metabolism of VPA toward predominantly peroxisomal -oxidation, resulting in excessive production and accumulation of -oxidation products, including 4-en-VPA a metabolite that is incriminated in VPA-induced hepatotoxicity

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doi: 10.1177/0885066620980399 Luis Caraballo, Shayan Mahapatra, Ves Dimov, Frank J Eidelman

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