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From an immunological perspective, these associations arise from a breakdown in self-tolerance mediated by overlapping T-cell and B-cell autoreactivity, shared cytokine pathways (e.g., IFN-, IL-18), and common antigen-presenting HLA alleles

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These findings might provide potential cues for developing therapeutic strategies for the management of MS in the future

The most common options outside hospitals are methylcobalamin and cyanocobalamin

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