“…There are acetyl-CoA carboxylase involved in fatty acid synthesis, pyruvate carboxylase involved in glucose metabolism, and propionyl-CoA carboxylase and f3-methylcrotonyl-CoA carboxylase involved in the catabolism of amino acids. Biotin depletion, therefore, causes metabolic abnormalities such as an impairment of glucose utilization [14][15][16], a reduced synthesis of prostaglandins (PGs) [17] and of their precursor fatty acids [18][19][20][21], and an accumulation of abnormal catabolites derived from amino acids [22,23]. However, no information is available concerning the effect of biotin depletion on these metabolic abnormalities in patients with SCCH, nor is it known whether the metabolic abnormalities are associated with the pathogenesis of the disorder.…”