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Further studies have shown the absence of GSH in T cells does not interfere with TCR signaling but leads to a failure to reprogram cellular processes needed for robust clonal expansion and prevents the induction of aerobic glycolysis and the increase in cell size associated with T cell activation (Klein Geltink et al., 2017)

Patients on long-term PPIs should have their B12 status monitored periodically, particularly if other risk factors are present

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