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This binding initiated biological responses, inhibition, or amplification of transmembrane signal transduction pathways ( + lymphocytes, play a crucial role in macrophage activation, differentiation, and induction of proinflammatory expression such as iNOS (Sol et al., 2021)

[31] [32] Histamine H2 receptor antagonists used to treat peptic ulcer disease and proton pump inhibitors used to treat gastroesophageal reflux disease can affect absorption of B12 and it is recommended to monitor the vitamin status in patients using them for prolonged periods