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Both open (Protein Data Bank (PDB) 3KAK) and closed (PDB 3KAL) active site forms of hGSH synthetases have been crystallized, with the phosphorylation and amide bond-forming steps proposed to be catalyzed in the closed form 52

However, laboratory studies have shown that various types of tumors have developed adaptations to survive and grow even in environments with limited glutamine (Zhang, EMBO J 2017), suggesting that restricting intake of glutamine from supplements or the diet may not be beneficial

Comparison of the Impact of 68Ga-DOTATATE and 18F-FDG PET/CT on clinical management in patients with neuroendocrine tumors