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525 Collectively, nanotechnology-based interventions have shown great potential in promoting AP therapy and deserve further research and development

The most balanced user reports consistently emphasize that the fundamentals, diet, exercise, protein intake, sleep, hydration, drove the majority of their results, and that the levocarnitine addition felt like a minor enhancement at best

Therefore, EBV may be involved in the brain-gut-microbiota axis communication in MS through various mechanisms, including affecting gut microbiota composition and metabolites, inducing an inflammatory microenvironment in the gut, damaging the intestinal barrier and influencing the phenotypes of immune cells in the gut and CNS by cooperating and antagonizing with the bacteria

While RWE is inevitably limited by the possibility of residual confounding [16], we welcome the careful attention paid by the authors of EMPRISE to minimise possible sources of bias [16], such as the steps taken to address concerns relating to immortal time bias that have been raised with previous RWE studies [19,20,21], providing more confidence in its results

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