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Methimazole is metabolized through cytochrome P450 (CYP) enzymes35,36 and flavoprotein mixed-function oxidase (FMO).37,38 Methimazole metabolism through CYP450 enzymes gives N-methylthiourea and glyoxal as two major metabolites.36 Nmethylthiourea is further oxidized with FMO enzyme to give sulfinic and sulfenic acid species.38 Glyoxal, is a reactive compound capable of interacting with different intracellular targets, such as proteins.39 Sulfenic acids are high electrophilic species that form irreversible adduct with cellular nucleophilic sites,40 and may have a role in methimazole-induced hepatotoxicity

10.1073/pnas.1111415108 18 GantnerB

[DOI] [PubMed] [Google Scholar] 59.Strubelt O, Siegers CP, Volpel M, Younes M

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BrinjikjiWKallmesDFVirmaniRde MeyerSFYooAJHumphriesWet alEndotheliitis and cytokine storm as a mechanism of clot formation in COVID-19 ischemic stroke patients: a histopathologic study of retrieved clots