The tetrahydrofolate pathway plays a key role in the metabolism of formic acid to non-toxic metabolitescarbon dioxide and water (Abrishami et al
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Cell 149, 274293, 10.1016/j.cell.2012.03.017 (2012)
In summary, synthesis of current evidence indicates that the gut microbiota acts as a key regulator of high-altitude adaptation, coordinating host physiology through integrated effects on energy metabolism, immune responses, and neuroendocrine signaling to maintain homeostasis (Table 1)