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Furthermore, the mutator mutS and mutL alleles contribute to reducing the genetic barrier to recombination (Davidsen and Tnjum, 2006), as it is known that MutS and MutL mismatch binding activity edit (prevent) homologous and homoeologous recombination, limiting the stability of heteroduplex intermediates, with the contribution of the RecBCD nuclease (tambuk and Radman, 1998)
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The final set of studies includes multiple randomized, double-blind, placebo- or active-controlled clinical trials (e.g., Bode 2010, Ji 2021, Husain 2019, Gerstein 2019, Kelly 2020, etc.), as well as several large-scale retrospective or prospective cohort studies from regions including Europe, Taiwan, the United States, and Nordic countries (e.g., Kornelius 2024, Chang 2025, Tagliapietra 2024, Ueda/Wadden 2024, and multinational database analyses)
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