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Important unanswered questions include: Long-term exposure Human pharmacokinetics Appropriate exposure levels Drug interactions Effects on methylation pathways Effects on NAD+ metabolism Effects across different tissues Potential off-target effects NNMT participates in normal metabolism, so researchers need to understand not only what happens when the enzyme is inhibited, but also what the consequences of sustained inhibition might be

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These structures are formed by RNA polymerase transcription initiation using the adenine moiety of NAD + rather than ATP, resulting in NAD + -capping of the RNA molecule