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From precorrin-6B to precorrin-8 [edit] The enzyme CobL has two active sites, one catalysing two methyl group additions and the other the decarboxylation of the CH 2 COOH group on ring D, so that this substituent becomes a simple methyl group: [21] precorrin-6B + 2 S-adenosyl methionine precorrin-8X + 2 S-adenosyl-L-homocysteine + CO 2 From precorrin-8 to hydrogenobyrinic acid [edit] The enzyme CobH catalyzes a rearrangement reaction, with the result that the methyl group that had been added to ring C is isomerised to its final location, an example of intramolecular transfer: [22] precorrin-8X hydrogenobyrinate From hydrogenobyrinic acid to hydrogenobyrinic acid a,c-diamide [edit] The next enzyme in the pathway, CobB, selectively converts two of the eight carboxylic acid groups into their primary amides

Current opinion in pulmonary medicine

This stacking approach requires careful timing and dose management

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Rev Med Toulouse