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These MVs carry not only CD38, but also CD39, CD73 and CD203a ectoenzymes, inhibitory complement receptors CD55 and CD59, the checkpoint inhibitor PD-L1, and the myeloma differentiation marker CD138 ( In addition to reducing surface CD38, antibody-induced modulation may involve two other mechanisms: i) signal transduction that activates intracellular signaling pathways, and ii) cargo transfer

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Specifically, nerve damage caused by vitamin B12 most often affects the extremities (hands and feet)