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This primary configurational difference at the C-20 position makes the -methoxyacrylate group in speciogynine and paynantheine perpendicular to the molecules plane, whereas the substituent at C-20 in mitragynine is planar (see Figure 3)

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Genome-scale metabolic models of hepatocytes have revealed serine deficiency in patients with non-alcoholic fatty liver disease (NAFLD), while the expression levels of SHMT1 and SHMT2 are significantly down-regulated in the livers of non-alcoholic steatohepatitis (NASH) patients, and PSPH, SHMT1, and BCAT1 (branched-chain amino acid transaminase 1) have been identified as potential therapeutic targets for NASH