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Since the formation of OAA from its precursor, malate, is thermodynamically unfavorable, the highly exergonic nature of the citrate synthase reaction is of central importance in keeping the entire cycle going in the forward direction, since it drives oxaloacetate formation by mass action principals

PLA 2 , phospholipase A 2

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Pill forms of the drugs simplify the entire process from manufacturing to administration, says Sean Wharton, an obesity medicine clinician and researcher at the Wharton Medical Clinic in Ontario