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Getting B12 into the bloodstream is a complicated possess with many steps

In response to localized inflammation, chemokines mediate the degradation of the glycocalyx, exposing receptors for binding to adhesion molecules, such as E-selectin on leukocytes and thus allow for immune cells to bind the endothelium and infiltrate the underlying tissue (241)

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Typically, this occurs when the virus reactivates during oral herpes recurrences and enters the central nervous system

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Treatments Treatment involves the addition of folinic acid salvage to methotrexate to reduce nonmalignant cell damage and cleavage of methotrexate into noncytotoxic metabolites using glucosidase