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The structure of cinaciguat (Cin) and heme (A), possible mechanisms for the replacement of ferric heme in sGC by cinaciguat (B and C). In (B), oxidized sGC loses heme and then cinaciguat binds and activates the apo form of the enzyme. In (C), cincaciguat is shown to play a direct role in ferric heme displacement forming a cinciguat-sGC complex.
