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Concurrently, PPIs, frequently prescribed to diabetic patients for gastroesophageal reflux disease management, impair protein-bound vitamin B12 release from dietary sources in the non-acidic gastric environment, with prolonged use ( 2 years) conferring a 65% increased risk of deficiency [159]

These findings suggest that restoring En2-regulated synaptic pruning or enhancing GABAergic synapse formation could rescue circuit imbalances in En2-associated ASD