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The proposed chain of effects looks like this: NNMT inhibited nicotinamide is no longer inactivated by methylation and becomes available for conversion to NAD+

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Smith J, Lopez R, Patel M, et al

Note that this is a one-way effect

This modulatory effect suggests a fundamentally different mechanism and a potentially superior safety profile for cardiovascular applications

1 for multiple sclerosis 2 for diabetes mellitus 1 for no discernible reason In the interval between the two data collection dates 11 patients had died or left the practice, this included both patients with diabetes