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Probiotic fermentation technology (PFT) has been reported to improve insulin signalling by modulating the gut microbiota, upregulating insulin receptor expression and activating PI3K/Akt signalling, followed by inhibition of GSK-3 and mTOR signalling, which leads to the downregulation of over-phosphorylated tau proteins in order to halt the development of memory and cognitive impairment (129)

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Macrophage activation is central to PNI pathogenesis, transitioning from a proinflammatory (M1) to an anti-inflammatory (M2) phenotype with distinct functions in inflammation and repair

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Sublingual therapy for cobalamin deficiency as an alternative to oral and parenteral cobalamin supplementation