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Given that the SLC39A8 p.Ala391Thr (rs13107325) variant has been associated with more than 22 clinical conditions, an important question is how this single missense variant can cause such a wide range of pathologies 44

Non-invasive mesotherapy techniques deliver excellent peptide penetration: microneedling (derma pen 0.5-1.0mm or derma roller 0.5mm), electroporation, iontophoresis, ultrasound-assisted delivery, or sonophoresis. For less invasive options, direct application with thorough massage also works, though penetration is less deep. The key is consistent applicationpeptides need to reach the dermal layer where they can affect muscle activity

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Given their non-invasive nature, accessibility, and cost-effectiveness of sublingual formulations, they may represent a promising approach for long-term B12 management, particularly in patients with impaired absorption or in resource-limited settings

Attacking ganglion cell death from multiple angles potentially superior to single mechanism