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[DOI] [PMC free article] [PubMed] [Google Scholar] 79.Di Naso FC, Simes Dias A, Porawski M, Marroni NA

In addition, severe IMDD is associated with a reduction in the levels of natural immunoregulatory substances, including Clara cell protein (CC16), which function as inhibitors of IRS activation [32]

The biology is unusual

The possibility that sustained folic acid intake would deplete vitamin B-12 independent of hematopoiesis suggests a plausible alternative mechanism based on the known details of the renal handling of holoTC, whereby folic acid might interfere with holoTC reuptake or cause its sequestration in the kidney, promoting the excretion of holoTC and further depleting metabolically active vitamin B-12 during vitamin B-12 deficiency