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We attributed these difficulties to the inaccessibility of PilQ epitopes due to the complex multilayered architecture of cyanobacterial cell envelopes

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Since the more mildly-affected participants often responded well to cofactor therapy alone, and that the side effects of the cofactors are generally much less than that of the medications [5 and author's experience], a trial of cofactor and dietary therapy alone may be warranted in most CVS patients encountered in clinical practice, with amitripyline or cyproheptidine added in refractory cases

et al., 2021), Verrucomicrobia and Subdoligranulum (Tao et al., 2019) showed a positive correlation