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Recently, a hybrid model (cuprizone autoimmune encephalitis or CAE) combining the myelin-toxic effects of cuprizone (Zirngibl et al., 2022) together with an immune stimulation identical to EAE but without extrinsic myelin peptides, provided proof-of-principle for the notion that a primary biochemical dysmyelination can result in a very typical inflammatory demyelinating white matter lesion in an immune-stimulated host (Caprariello et al., 2018)

However, B12 is unique: whilst it is water-soluble, the liver stores substantial reserves lasting several years

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Multi-dose vials: Each needle puncture creates potential entry point for contaminants After 10-15 punctures, seal integrity weakens Recommendation: Use vial within 28 days even if seal appears intact Single-dose draws: If drawing entire vial in one session, seal integrity not an issue Can preload syringes for convenience (store in fridge, use within week) Extending shelf life: tips and tricks While 28-30 days is standard, these practices maximize longevity

Timing Baseline Monitoring guidance is pathway-based and cautious because SLU-PP-332 has limited human monitoring data

[2] As a 503B-compounded medication, it is not an FDA-approved commercially marketed drug