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It is proposed that the C* domain located at the C-terminus of CesAand the TE domain located at the C-terminus of CesB works as a cooperative esterification and depsipeptide elongation center, repeatedly recruiting the action of the C* domain to oligomerize tetradepsipeptides to give octa- and dodecadepsipeptides prior to macrocyclization by the TE domain

Understanding the physiological mechanism can help distinguish expected adaptation from concerning symptoms requiring clinical review

Additionally, the twins parents implemented a rigorous diet and nutrition intervention around the time of diagnosis

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Pausing your medication for more than a few weeks may require going back to a starter dose and restarting the long process of working up to a full-strength dosage