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doi: 10.1042/BSR20210611

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I/R injury is related to the decrease of endogenous NAMPT and the down-regulated expression of SIRT1, SIRT3 and SIRT4

At the cellular level, B12 acts as a cofactor for two critical enzymatic reactions: Methionine synthase converts homocysteine to methionine, essential for DNA methylation and synthesis Methylmalonyl-CoA mutase involved in fatty acid metabolism and myelin production By restoring adequate B12 levels, injections enable normal red blood cell maturation in the bone marrow, correcting the megaloblastic anaemia