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The -glutamyl residue forms 5-oxoproline, which by the action of 5-oxoprolinase, yields glutamate
Symptoms Severe vitamin E deficiency results mainly in neurologic symptoms, including impaired balance and coordination (spinocerebellar ataxia), injury to the sensory nerves (peripheral neuropathy), muscle weakness (myopathy), and damage to the retina of the eye (retinopathy)
The caloric deficit also means reduced protein availability for tissue synthesis, reduced micronutrient availability, and potentially reduced copper delivery to the enzymatic systems that GHK-Cus carrier function bypasses
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