HTL can damage proteins through "homocysteinylation" of protein lysine residues.[1] HTL has been reported to form isopeptide bonds with lysine residues in substrate proteins, a post-translational modification known as N-homocysteinylation (N-hcy). This causes protein damage via a thiyl radical mechanism.[2] The drugs citiolone and erdosteine are modified versions of homocysteine thiolactone.
^Jakubowski, Hieronim (February 2000). "Homocysteine Thiolactone: Metabolic Origin and Protein Homocysteinylation in Humans". The Journal of Nutrition. 130 (2): 377S –381S. doi:10.1093/jn/130.2.377S. PMID10721911.
^Perła-Kaján, J.; Twardowski, T.; Jakubowski, H. (2007). "Mechanisms of homocysteine toxicity in humans". Amino Acids. 32 (4): 561–572. doi:10.1007/s00726-006-0432-9. PMID17285228.