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When B12 enters the digestive system, it is initially bound to proteins in food

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The primary defect is missense mutation in the HFE gene resulting in a cysteine to tyrosine substitution at aminoacidic 282 (C282Y), a protein that interacts with transferrin receptor 1 (TfR1) and regulates the expression of hepcidin, a key regulator of iron metabolism represented in Diagram B of Figure 2

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Furthermore, GM-CSF strengthens immune recognition of cancer cell neoantigens by fostering antigen, presenting cell generation, and elevating major histocompatibility complex (MHC) expression, thereby reinforcing the overall immune response against tumors (23, 68)