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(4) If youre taking B12 orally, sublingual B12 is effective because it bypasses absorption in the stomach, meaning you dont need sufficient levels of intrinsic factor to absorb it

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Kynurenine, a metabolite of tryptophan, upregulates T-cell PD-1 levels by inducing and activating the aryl hydrocarbon receptor (AhR), while AhR upregulates transporters to promote T cells to uptake kynurenine, forming a positive feedback loop and inhibiting anti-tumor immune responses (Liu et al., 2018)