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Other -methylene--butyrolactones have been reported as sensitizers such as oxyfrullanolide 5, cis-b-cycloscotunolide 6, and eremofrullanolide 7.3537Frullania dilatata (L) Dum contains exclusively the d- or (+)-enantiomer of frullanolide while Frullania tamarisci (L) Dum exclusively yields the l- or ()-enantiomer.36 Both enantiomers are sensitizers, and in guinea pigs the stereospecificity of sensitization to one enantiomer has been demonstrated36,37 (Fig

Over time, this can lead to chronic kidney disease (CKD) or even kidney failure

The chemistry gives those notes a real foundation

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