In vitamin B 12 deficiency, methionine block implies that SAM (driven by Met) is lowered as well and hence it is plausible CBS is less effective
The underlying mechanisms are complex, involving direct and indirect toxic effects, immunologic dysregulation, and oncogenic pathways, primarily driven by oxidative stress, systemic inflammation, insulin resistance, and the presence of numerous carcinogens in tobacco smoke
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References: National Research Council (US) Committee on Diet and Health