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Bacterial defense mechanisms within the biofilm, such as CRISPR-Cas systems, plasmids, genomic islands, modification and mutation of surface receptors, or production of substances that inhibit phage attachment, prevent bacteriophages from infecting and eliminating biofilm communities (Rmling and Balsalobre, 2012

A 2011 clinical study (phase III trial) has shown that a vaccine targeting a unique molecular structure on certain lymphoma cells improved disease-free survival in follicular lymphoma patients who were already in a minimal residual disease state (ie, had a complete response after 6 to 8 months of combination chemotherapy) (Schuster 2011)

Ammonia readily crosses the blood-brain barrier and is thought to inhibit glutamate uptake, thereby increasing extracellular glutamate concentrations in the brain and resulting in activation of NMDA receptors

Conclusion VPA poisoning is responsible for life-threatening manifestations with mildly prolonged VPA elimination