2-Epimerase was discovered as a target because it was one of the enzymes in the biosynthetic pathway for synthesizing an essential neutral polysaccharide in the cell wall of B. anthracis (Glu:Gal-NAc:Man-NAc at a 3:2:1 ratio).
These folate-dependent biosynthetic reactions include the transfer of methyl groups from 5-methyltetrahydrofolate to homocysteine to form formyl groups from 10-formyltetrahydrofolate to N-formylmethionine in initiator tRNAs.
Patients have markedly reduced whole-body cholesterol biosynthesis associated with suppressed hepatic, ileal, and mononuclear leukocyte hydroxymethylglutaryl-coenzyme A reductase (HMG-CoA reductase), the rate-controlling enzyme in the cholesterol biosynthetic pathway.
(p)ppGpp is thought to bind RNA polymerase and alter the transcriptional profile, decreasing the synthesis of translational machinery (such as rRNA and tRNA), and increasing the transcription of biosynthetic genes.