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In line with the concept that T cell activation and differentiation require metabolic adaptation, SLC1A5 couples TCR and CD28 signals to ultimately activate the mTORC1 pathway and enable the cell to undergo clonal expansion (105)

Elevated MMA levels in patients with vitamin B12 deficiency can contribute to myelin damage (myelopathy) and, consequently, peripheral and autonomic neuropathy ( Cobalamin deficiency can lead to neurological manifestations such as progressive axonal demyelination, impaired peripheral and sensory nerve function, areflexia, loss of proprioception and vibration sensitivity, and subacute combined spinal cord degeneration (70)