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The BBB is a highly selective semi-permeable barrier that exists between the CNS and blood

Overgrowth of bacteria: Some people develop vitamin B 12 deficiency as a result of conditions that slow the movement of food through the intestines (diabetes, scleroderma, strictures, diverticula), allowing intestinal bacteria to multiply and overgrow in the upper part of the small intestine

The 2020 systematic review by Galeano and colleagues across 34 eligible studies confirmed the mechanism: PDRN promotes physiological tissue repair through salvage-pathway nucleotide recycling and A2A receptor activation [32]