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Salvage occurs at a lower rate in the blood compared to other tissues, where PreissHandler may even be the preferred pathway 11

casei Shirota is the dominant thiol/disulphide redox system and the trxA1 trxA2 & trxB mutants of the strain have severely damaged growth rate which is restored after addition of glutathione in the medium [35]

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Some clinicians might choose to challenge him again with gluten to see if his symptoms worsen again, while other clinicians might have him stay off the gluten for 3-4 months as he works on improving the health of his GI ecosystem