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The reduction in total drug delivered to the systemic circulation is referred to as the First Pass Effect - reflecting the loss of drug via its first pass thru the GI tissues & liver before it reaches the systemic circulation

Moreover, disrupted methylation due to Cbl oxidation has been linked to reduced lymphocyte proliferation and direct effects on cytokines and growth factors, impacting immune system function [51]

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It is worth noting that at the 10-week time point in the remyelination process, the four diffusion tensor metrics indicated the continual destruction of the sCC structure and the exacerbation of demyelination, while the T 2 -nor value was instead reduced