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Mechanistic evidence relies heavily on animal studies (e.g., mouse neurotransmitter experiments) with insufficient large-scale human randomized controlled trials (RCTs) to confirm causality

54 However, previous studies have also demonstrated that MSCs are capable of secreting anti-inflammatory cytokines, anticatabolic mediators, and growth factors when cultured under IDD-like conditions both in vitro 55 and ex vivo, 56 hence demonstrating an immunomodulatory effect on resident IVD cells

Muranyi M, Ding C, He Q, Lin Y, Li PA

Next, we evaluated the brain metabolomic and transcriptional profiles of Tbx1 +/ and WT mice treated postnatally with vB12 or PBS as described above (Group 3 in Fig S1C, Tables S1 and S2)