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In this perspective, the reaction catalyzed by pyruvate carboxylase plays an anaplerotic function, catalyzing the formation of oxaloacetate

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Adjunct drugs such as catechol-O-methyltransferase (COMT) and monoamine oxidase-B (MAO-B) inhibitors lack specificity to the central nervous system (CNS), have poor BBB permeability, and result in systemic side effects 15,16