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The ECM not only determines tissue structure but also regulates many cellular processes through determining the bio-availability of cytokines, chemokines and growth factors, 85,86,87 and by directly influencing the migration and activation of cells 83,88 hence influencing immune responses

It is possible that some people who develop symptoms of a vitamin B12 deficiency with no clear causative factors may have antibody-negative pernicious anaemia[2]