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A translational review on NNMT inhibitor clinical development ( Emerging opportunities for NNMT inhibitor clinical translation , ScienceDirect, 2026) points out that alternative routes like polyamine biosynthesis could compensate for the raised SAM, and that partial rather than total inhibition might even be preferable specifically to avoid triggering those compensatory mechanisms from a chronically imbalanced SAM/SAH ratio

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[21] administered a three times higher dose (0.15 mg/kg) IV, resulting in an initial concentration of 90 ng/mL at t = 2 min