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The final products of peroxisomal -oxidation can reach mitochondria after conjugation with carnitine trough carnitine octanoyltransferase (CrOT) (whose substrates are medium and long-chain fatty acyl-groups) or peroxisomal carnitine acetyltransferase (CrAT), which is more active toward short-chain acyl-CoAs [18, 66]

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Furthermore, they demonstrated clinically relevant benefits, including a reduced requirement for exogenous pulmonary surfactant (both in the number of infants needing treatment and the total dose administered) and a shortened duration of mechanical ventilation compared to the placebo group (73)