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Concentrations were based on previous studies, and cells were incubated at 37C with 5% CO2 for 4 h ( CD4 + T cells were plated at a density of 1 10 6 cells/well in 24-well plates in 1 ml RPMI 1640 complete medium containing fumaric acid (173 M) or dimethyl sulfoxide (DMSO,ST038, BYT, Shanghai, China) as a vehicle control

Any references to neurological or neurochemical pathways are included only to summarize scientific literature and are not claims of safety, efficacy, or suitability for human or animal use

Despite this, the consistent directionality of mechanistic effects particularly Nrf2 activation, nitric oxide restoration, and angiogenic normalization suggests a coherent physiological signal worth pursuing further

ZY, YH, and HM: review and editing