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Kynurenine, a metabolite of tryptophan, upregulates T-cell PD-1 levels by inducing and activating the aryl hydrocarbon receptor (AhR), while AhR upregulates transporters to promote T cells to uptake kynurenine, forming a positive feedback loop and inhibiting anti-tumor immune responses (Liu et al., 2018)

Studies show that NNMT inhibition by 5-amino-1-methylquinolinium significantly reduces nicotinamide metabolism, increases NAM accumulation, improves NAD+ synthesis efficiency by over 30%, and markedly increases mitochondrial ATP production and cellular energy metabolism

GSTO1*E155del polymorphism associated with increased risk for late-onset Alzheimers disease: association hypothesis for an uncommon genetic variant

Studies have shown that it remains effective and works systemically this way (1, 19)