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Dorian Yates Blackbombs . ,

doi: 10.1016/j.ynpai.2019.100034 84 FlattersS

It is a pleiotropic peptide with vascular and inflammatory signaling effects

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Prior to excretion, SN-38 is sent to the liver where uridine diphosphate glucuronosyltransferase (UGT) enzymes attach a glucuronide group to the SN-38 scaffold, converting it to the inactive metabolite SN-38-glucuronide (SN-38-G), which is non-toxic

The defect in ATP generation is unlikely to be the sole cause, as ATP deficiency is difficult to demonstrate in many patients and other disorders with more severe ATP deficiency are not associated with significant hemolysis