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It is possible that MDMA and/or its reactive metabolites (including N -methyl--methyldopamine, orthoquinone, and quinone thioesters) [2729, 31] suppress the mitochondrial function by directly inhibiting the activities of mitochondrial complexes I, II, IV, and V [36, 44] or interacting with various proteins in the mitochondria [31]

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also referred to as prohormone convertase 2) action leads to the release of glucagon