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Mtb can also incorporate propionyl-CoA into its cell wall, including the virulence-associated lipids phthiocerol dimycocerosates (PDIM) and the trehalose ester family (sulfolipid-1 (SL-1), diacyltrehalose, triacyltrehalose, and polyacyltrehalose), which are synthesised from malonyl-CoA (produced from acetyl CoA) and methylmalonyl-CoA (produced from propionyl-CoA) (Lee et al, 2013)
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The peptide sequence, derived from human growth hormone, appears sufficiently similar to native proteins that the immune system does not mount a response against it
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