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3.3 Immune system enhancement The natural substances can act as immune checkpoint and co-inhibitory modulators, some polyphenols decrease the expression of tissue-and tumoural PD-L1 or of CTLA-4 on T cells giving a mechanistic reasoning to combination with nutritional support in patients treated with check point inhibitors, eventually reversing acquired resistance to treatment or decreasing the effective dose for drug administration (193)

Maruyama T, Miyamoto Y, Nakamura T

The principle is based on probability of recombination is related to (1) length on the chromosome and (2) number of generation (number of meiosis)

Corcorran, MD, MPH Associate Editor Associate Professor of Medicine Division of Allergy & Infectious Diseases University of Washington Disclosures : None Reviewer: H

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Hepatitis B virus: a comprehensive strategy for eliminating transmission in the United States through universal childhood vaccination