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First, in the cytosol, VPA is activated and links with reduced acetyl coenzyme A (CoA-SH) to form valproyl-CoA (by the ATP-dependent medium-chain acyl-CoA synthetase, located on the outer side of the mitochondrial membrane)

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This pathway has been studied in several in vitro models and is under investigation as a potential therapeutic target in several cancers, including breast, ovarian, liver, and prostate 15,16,17,23

After the research period, mid-diaphyseal peripheral quantitative computed tomography (pQCT) scans were conducted on the femurs of the subjects