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New England Journal of Medicine (2025) 2

As for DED, our previous research acknowledged that AST suppresses inflammation by downregulating the expression of HMGB1 and inflammation in DED models via the PI3K/Akt signaling pathway (Li et al., 2020)

The VIGS-mediated high throughput methodology that we have described in this manuscript has several advantages to analyze the functional role of putative stress-induced genes

Conditions include alcoholic liver disease, viral hepatitis, cirrhosis, and primary or metastatic liver cancer Renal dysfunction : Impaired kidney function reduces B12 elimination, causing accumulation even with normal intake Haematological conditions : Myeloproliferative neoplasms, chronic myeloid leukaemia, polycythaemia vera, and hypereosinophilic syndrome increase transcobalamin production, elevating total serum B12 Laboratory interference : Macro-B12 (immunoglobulin-bound B12) and assay interference can cause spuriously elevated results without true excess In clinical practice, unexplained hypercobalaminaemia should prompt investigation for underlying disease, particularly in patients without obvious supplementation history