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Information here is drawn from the published trial record, FDA regulatory documents, and animal studies

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Regarding the SEV group, B12-upregulated genes had GO annotations related to cytoplasmic translation (tRNA and rRNA processing), adaptive immune response, ncRNA processing, miRNA-mediated gene silencing, proteasome-mediated ubiquitin-dependent protein catabolic process, cobalamin transport, and negative regulation of transcription by RNA polymerase II ( Figure S3 )

Deficiency in vitamin B12 can lead to the accumulation of methylmalonyl-CoA, which is subsequently converted to methylmalonic acid (MMA) (, , )

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