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the acyl-group of the acyl-CoA is transferred to carnitine, and the acyl-carnitine is imported through both mitochondrial membranes before being transferred to a CoA molecule, which is then beta oxidized to acetyl-CoA

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Second, a reduction in tubular reabsorption of both free carnitine and acylcarnitine has been reported during VPA treatment [45,46], Third, VPA reduces endogenous synthesis of carnitine by blockade of the enzyme butyrobetaine hydroxylase

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