There are two 2HG enantiomers: D-2-hydroxyglutarate (D2HG) and L-2-hydroxyglutarate (L2HG), with the former predominantly generated from IDH1 mutants and PHGDH while L2HG is primarily generated from the promiscuous activity of LDHA and MDH1/2 under hypoxic or acidic conditions and converted back to 2OG by L2HGDH
Schtt U, Solomon C, Fries D, Bentzer P
Energy You Can Feel
The responsible framing is that the barrier and the immune system are intimately linked, that permeability is a plausible and partly validated contributor, and that the full causal picture is still being worked out
A few commenters recommended using thresholds based on standard deviations below the mean, which would limit 1-star reductions to a smaller proportion of hospitals and more precisely target those with significantly lower Safety of Care performance
However, further clinical trials are required to definitively establish its safety profile and long-term effects