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At the molecular level, DON disrupts eukaryotic protein synthesis by binding to ribosomes, which leads to a ribotoxic stress response that activates mitogen-activated protein kinases (MAPKs)

A complete blood count often reveals associated leukopenia and/or thrombocytopenia

On the basis of biochemical characterization of their bacterial orthologs, these enzymes, respectively, are known to sequentially catalyze the addition of -ketoglutarate 48 (ultimately providing the succinyl side chain of OSB) to form SEPHCHC, the 2,5-elimination of the pyruvyl side chain to form SHCHC, 49 and dehydration to produce OSB, 50,51 the aromatized ring of which serves as the benzene moiety (ring A ) in the eventual 1,4-naphthalenoid structure of DHNA (Figure 2)

For detailed reconstitution protocols, see the Reconstitution Guide