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Neumann, I

290,291,292 Accumulating macrophages release cytokines and chemokines, including IL-1, IL-6, chemokine ligand 2 (CCL2), and TNF-, intensifying the inflammatory environment and aggravating nerve damage

If you reconstitute a powder and see clear solution instead of pink, you know immediately that either the B12 was omitted or the concentration is extremely low