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Even kynurenine produced by these EBV-transformed B cells inhibits NKG2D expression in nearby NK cells through the c-Jun N-terminal kinase pathway to escape NKG2D-mediated attack by immune cells [320, 326]

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Incidentally, the healthy reference range is 191-663 pg/ml and correlates closely with oral cobalamin intake, which is why the vitamin B12 blood level alone is not an adequate parameter to diagnose a deficiency (Herrmann and Obeid, 2014)