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For D-R9 and insulin complexation, covalent conjugation of D-R9 to insulin, not their coadministration, is necessary for the translocation through rat pulmonary alveolar epithelium (Patel et al., 2009)

The closest structural relative was found to be human CLIC1 (PDB code 1K0O), in which 156 C could be aligned with a root-mean-square deviation (RMSD) value of 0.93 , followed by GSTO1 from Homo sapiens (PDB code 3LFL) (122 aligned C with an RMSD of 2.07 ) and the putative stringent starvation protein A from Burkholderia cenocepacia (PDB code 4QQ7) (122 aligned C with an RMSD of 2.14 ) 12,15

32 Consequently, the FDA requested manufacturers to voluntarily withdraw their products from the market due to these safety concerns

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Associated symptoms included nausea and transient dyspnea during pain episodes