2-Hydroxyisovaleric acid (also known as 2-Hydroxy-3-methylbutyric acid) is a metabolite found in the urine patients with acidosis and diabetic ketoacidosis. The concentration of this metabolite was also abnormal high in the urine of severely asphyxiated group. In case of maple syrup urine disease, when also the concentration of the 2-hydroxyisovaleric acid was increased in the urine, was made a suggestion, that the early diagnosis and proper treatment can prevent brain damage and improve prognosis.

N-acetylmuramic acid (MurNAc) is a bacterial cell wall component. Peptidoglycan, also called murein, is a polymer that consists of long glycan chains that are cross-linked via flexible peptide bridges to form a strong but elastic structure that protects the underlying protoplast from lysing due to the high internal osmotic pressure. The peptidoglycan is the only cell wall polymer common to both gram-negative and gram-positive bacteria. The glycan chain is built up of alternating, β-1,4-linked N-acetylglucosamine (GlcNAc) and N-acetylmuramic acid (MurNAc) subunits. The chemistry of the glycan chains varies only slightly between different bacteria.