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In the extracellular environment, cysteine is oxidized to form cystine, a dimer of two cysteine molecules joined by a disulfide bond

The ACMS intermediate can be metabolized via the action of the enzyme ACMS decarboxylase encoded by the ACSMD gene

[DOI] [PMC free article] [PubMed] [Google Scholar] 334.Zhong Q., Mishra M., Kowluru R.A

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166 In a randomized controlled trial that enrolled 100 subjects with slightly to moderately high cholesterol levels, 2,000 FUs of nattokinase per day for eight weeks prolonged measures of clotting time (collagen-epinephrine closure time and activated partial thromboplastin time) more than placebo