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The interesting part of this study is that there was no separation of patients by underlying cause of knee pain

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This striking distinction between the WT BoNT/E and D3 starting points is consistent with our findings from the three substrate variant evolutions, and strongly suggests that starting point redesign expands the productive mutation space of an evolving enzyme, enabling the emergence of new genotypes with virtually absolute specificity reprogramming not attained by evolving the natural enzyme