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Mechanisms investigated Metabolic-pathway research converges on a small set of enzymatic and receptor targets, and these compounds map onto different ones — they are not interchangeable: NNMT inhibition (5-Amino-1MQ): studied as a small-molecule inhibitor of nicotinamide N-methyltransferase, an enzyme implicated in cellular NAD⁺/SAM metabolism

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The therapeutic framework presented herein is not intended to supplant the Shoemaker Protocol but to supplement it through mechanistically grounded botanical options that may offer benefit in treatment-resistant or relapsing CIRS cases