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Severe B12 deficiency is a health issue, not just feeling tired

Apart from fundamental competition for nutrients required by cancer cells and immune cells in TME, metabolic pathways change in tumor cells may influence tumor-infiltrating immune cells, and different immune cell subgroups in TME have specific metabolic characteristics (282)

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First-pass effect An effect in which the concentration of a drug is greatly reduced via presystemic metabolism before it reaches the systemic circulation