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Five mammalian carboxylases are known to require biotin for their biological activity: acetyl-coenzyme A (CoA) carboxylases 1 and 2, pyruvate carboxylase, propionyl-CoA carboxylase, and methylcrotonyl-CoA carboxylase

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This is important to know, prior to suggesting an efficient long-term treatment or prevention strategy

Peak maintenance dose at discontinuation plays a measurable role in symptom duration