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Corticosteroid medication mimics glucocorticoids, more specifically, a glucocorticoid called cortisol. The Immune System Corticosteroids are well-known for increasing a patients risk of infection

J Neurooncol 120:489497

This mitochondrial dysfunction also triggers the release of mitochondrial DNA, ROS, cytochrome c, and other damage-associated molecular patterns (DAMPs) into the extracellular space, where they act as alarmins, activating microglia and astrocytes via particular receptors like TLR4, TLR9, P2X7R, and RAGE, among others [60]

In contrast R proteins bind cobalamin less avidly and undergo proteolysis when they come into exposure to the more alkaline environment of the small intestine (SI) (72)