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The first step consists in the introduction of a double bond between the C2 and C3 by the enzyme acyl-CoA-dehydrogenase to produce a trans -2-enoyl-CoA while flavin adenine dinucleotide (FAD) is reduced to FADH 2

ROS can activate pro-inflammatory signaling pathways, leading to the release of cytokines and the recruitment of immune cells to the site of injury [58]

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However, in guidelines published in 2012, the British Columbia Medical Association (Canadian Ministry of Health) recommended a dose of 1000 g/day for pernicious anemia or food-bound cobalamin malabsorption [34]

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