Figure 7.

Possible mechanisms by which 5-ALA-HCl + SFC increases ATP production without CI. The components upregulated and downregulated by 5-ALA-HCl + SFC are colored orange and blue, respectively. Sicily knockdown causes loss of CI, whereas upregulation of CII compensates for the lack of electron transfer in CI. Upregulation of CIII and CIV increases the number of protons pumped into the IMS. 5-ALA-HCl + SFC may also affect other ATP-synthesizing reactions, including glycolysis, the TCA cycle and β-oxidation, which in combination may counteract the accumulation of lactate and pyruvate and increase ATP synthesis.