An alternative TCA cycle generates oxalate and ATP as a consequence of Al toxicity.

(↓) represents a decrease in enzyme activity whereas (↑) represents an increase in activity. AGODH  =  acylating glyoxylate dehydrogenase, SCS  =  succinyl-CoA synthetase, ICL  =  isocitrate lyase, MS  =  malate synthase, ACN  =  aconitase, NAD-ICDH  =  NAD-dependent isocitrate dehydrogenase, SDH  =  succinate dehydrogenase, FUM  =  fumarase, OCT  =  oxalate CoA-transferase, and KGDH  =  α-ketoglutarate dehydrogenase, CS  =  citrate synthase, MDH  =  malate dehydrogenase.