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Mutations identified in patients with defective lipoic acid metabolism affect genes involved in the synthesis of iron-sulfur clusters and genes coding for lipoic acid synthetase ( LIAS ), lipoyl transferase 1 ( LIPT1 ), and dihydrolipoamide dehydrogenase (E3 component of -ketoacid dehydrogenase complexes

doi: 10.1056/NEJMoa2107519 113 EhsesJACasillaVRDotyTPospisilikJAWinterKDDemuthHUet al

Overstimulation of metalloproteinases (MMPs), enzymes that break down collagen and elastin