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Synonyms Focal melanosis Definition A localized, pigmented lesion due to an excess of melanin in the basal cell layer and/or lamina propria of the oral mucosa (Kaugars et al

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Interestingly, the aryl hydrocarbon receptor (AhR) of the tryptophan-kynurenine pathway serves as a critically important mediator between tryptophan metabolism, immune reactions, and tissue homeostasis (4143), and several kynurenine metabolites have been associated with fatigue (44, 45)

Mitochondrial dysfunction can result in intracellular lipid accumulation, leading to lipid toxicity, lipid peroxidation, and a series of pathological processes that ultimately cause further mitochondrial fragmentation, dysfunction, and even cell death [47, 48]

In addition, a previous study identified 38% of their patients taking valproic acid and 24% taking carbamazepine had hypocarnitinemia