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6101, et seq

Chemical structures of lipoic acid and lipoyllysine residue The figure illustrates the chemical structures of lipoic acid in its oxidized and reduced forms, its two enantiomers ( R - and S -lipoic acid), and its covalent attachment to a lysine residue of the E2 component of the -ketoacid dehydrogenase complex (and the H protein of the glycine cleavage system), forming a lipoyllysine moiety

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Although these compensatory mechanisms attempt to restore immune homeostasis, a subtype of patients develops persistent inflammation, immunosuppression, and catabolism syndrome (PICS), which is predictive of a poor outcome