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(2014) 6:a016295

The innate and adaptive immune systems

Rudenski AS, Hosker JP, Burnett MA, Matthews DR and Turner RC

Assessment considerations include: Serum B12 measurement may be considered before initiating Ozempic in high-risk patients (those on metformin, older adults, those with gastrointestinal symptoms, or with restricted diets) Testing for B12 deficiency should be performed in patients on metformin who develop symptoms suggestive of deficiency, as advised by the MHRA Drug Safety Update Consider periodic monitoring in patients with risk factors for B12 deficiency, rather than routine annual testing for all patients Full blood count to identify macrocytic anaemia, which may indicate B12 or folate deficiency Clinical assessment for symptoms of deficiency: fatigue, paraesthesia, cognitive changes, glossitis, or balance problems If B12 levels are borderline or if clinical suspicion remains despite normal serum B12 (measured in pmol/L, with laboratory-specific reference ranges), additional testing may be considered according to local laboratory protocols

A key component of the antioxidant defense machinery is the transcription factor Nuclear factor erythroid 2-related factor 2 (NRF2), which regulates enzymes that mitigate oxidative damage in GCs, oocytes, and preimplantation embryos (Amin et al., 2014

Figure 4 Histological examination of lung tissue from IL-33 challenged Rag2 - / - GC - / - mice revealed that adoptive transfer of activated ILC2s induced marked immune cell infiltration into the lung parenchyma and significant thickening of the airway epithelium compared with no-transfer controls ( Figures 4B, C, E, F )