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Despite decades of research and medical advancements, significant challenges remain

1) are dysregulated in response to the GDH2 gene deletion, or these pathways are unable to generate sufficient glutamate inside the cells and the large pool of free NADP + required to overcome the thermodynamic barrier inherent in using the still present Gdh3, which is usually an anabolic enzyme with a higher affinity for -ketoglutarate than for glutamate

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In contrast, another study showed that cardiomyocyte-specific glucocorticoid receptor ablation in mice delayed postnatal cardiomyocyte cell cycle exit, hypertrophic growth, and cytoarchitectural maturation 57

The usual clinical aspect is a grey, bluish-grey or black macular stain, which is usually seen on the gingival or alveolar mucosa