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These released exosomes can then modulate immune response in other cells through a payload of inflammatory cytokines, like TNF-alpha, or through microRNA s that decrease inflammation.[ref] Mast cell release of exosomes has been shown to increase the formation of collagen in fibroblasts, which can lead to fibrosis (including pulmonary fibrosis, IPF)

Histological analysis of lung sections further confirmed that L-carnosine substantially ameliorated the pathological features of lung injury, including alveolar wall thickening, inflammatory cell infiltration, and alveolar collapse (Figures 4D, E)

These changes correlate with improved metabolic health independent of weight loss magnitude

So do your homework when it comes to B12 to determine which form may be best tolerated and most beneficial for you