Two mechanisms of action are proposed for pantethine. In the first, pantethine serves as the precursor for synthesis of coenzyme A. CoA is involved in the transfer of acetyl groups, in some instances to attach to proteins closely associated with activating and deactivating genes.
Two ways that pantethine works are proposed: it can be used to create coenzyme A, which helps transfer acetyl groups to proteins that control gene activation and deactivation.