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The regulatory features of BCAAs in macrophage polarization are mainly reflected in their role as an intersection node linking nutrient sensing-mTOR signaling-energy metabolic coupling. After entering cells, BCAAs can be converted by BCAT into branched-chain -keto acids, which are further catabolized by the BCKDH complex to generate products such as acetyl-CoA, succinyl-CoA, or propionyl-CoA, thereby connecting to the supply of TCA cycle intermediates and mitochondrial oxidative metabolism (62)

To avoid repetition and because no clinically useful blood or CSF biochemical biomarker specific for PD is still available, we will only briefly discuss a few of these biomarkers

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When GA is administered, AMPK is phosphorylated, and acetyl-CoA carboxylase 1 (ACC1) and ACC2 are both inactivated by AMPK, therefore inhibiting the conversion of acetyl-CoA to malonyl-CoA, thus blocking fat synthesis (J et al., 2023)