Because malate dehydrogenase is closely tied to the citric acid cycle, regulation is highly dependent on TCA products.[12] Citrate also affects MDH activity by very complex manner. It inhibits the reduction of oxaloacetate under all conditions. Citrate also inhibits malate oxidation, but only at low malate or NAD concentrations. While citrate shares similar hydrogen bonding patterns with oxaloacetate, the presence of an additional carboxyl group results in competitive inhibition with respect to NADH that could be the result of introduced steric hindrance with the nicotinamide ring of the cofactor.[9][13] When both malate and NAD concentrations are high (10 mmol/L and 5 mmol/L, respectively), citrate can actually augment MDH2 activity.[14] All three effectors (malate, oxaloacetate and citrate) bind to the same putative allosteric site.[12] MDH2 has also been shown to be competitively inhibited by ATP and adenosine nucleotides in general. By occupying the Rossman fold domain, they prevent the binding of NAD/NADH while also stabilizing the dimer structure over the catalytically preferred tetramer structure.[9][10][13] Recent studies of mitochondrial malate dehydrogenase are focused into the nature of the inactivation processes. The oligomeric structure of MDH2 has a variety of biological implications. Some researches have suggested that the dimeric structure is critical for enzymatic activity. It was first proposed that the reciprocating compulsory ordered mechanism where each subunit alternates as the active and the helper subunit, but both are needed for activity. This mechanism predicts an inactive monomer, and was corroborated by studies that showed a dramatic reduction of enzymatic activity.[15] Studies with mitochondrial MDH2 have shown that this enzyme is allosterically regulated as a complex as well. Binding experiments indicate that mitochondrial aspartate aminotransferase can associate with the alpha-ketoglutarate dehydrogenase complex and that mitochondrial malate dehydrogenase can associate with this binary complex to form a ternary complex. Formation of this ternary complex enables low levels of the alpha-ketoglutarate dehydrogenase complex, in the presence of the aminotransferase, to reverse inhibition of malate oxidation by glutamate. Thus, glutamate can react with the aminotransferase in this complex without glutamate inhibiting production of oxaloacetate by the malate dehydrogenase in the complex. The conversion of glutamate to alpha-ketoglutarate could also be facilitated because in the trienzyme complex, oxaloacetate might be directly transferred from malate dehydrogenase to the aminotransferase. In addition, association of malate dehydrogenase with these other two enzymes enhances malate dehydrogenase activity due to a marked decrease in the Km of malate. The potential ability of the aminotransferase to transfer directly alpha-ketoglutarate to the alpha-ketoglutarate dehydrogenase complex in this multienzyme system plus the ability of succinyl-CoA, a product of this transfer, to inhibit citrate synthase could play a role in preventing alpha-ketoglutarate and citrate from accumulating in high levels. This would maintain the catalytic activity of the multienzyme system because alpha-ketoglutarate and citrate allosterically inhibit malate dehydrogenase and dissociate this enzyme from the multienzyme system.[16]