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A 2020 update did caution, however: Based on the currently available evidences, the role of ALC [acetyl-L-carnitine] in AD and other cognitive disorders is still under debate

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Furthermore, the genomic landscape revealed a network of enzymes capable of interconverting different B 6 vitamers, including pyridoxine 5-phosphate oxidase (PdxH), sugar phosphatases, pyridoxine 4-dehydrogenase, pyridoxal kinase, and PMP oxidase