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It was identified through a medicinal chemistry programme at the University of Texas Health Science Center as the lead NNMT inhibitor candidate among a series of 1-methylquinolinium analogues bearing primary amine substitutions, selected for its combination of high passive membrane permeability (confirmed in PAMPA assays), high active transport membrane permeability (confirmed in bidirectional Caco-2 cell assays), potent NNMT inhibitory activity, and high selectivity including confirmed absence of inhibitory effects on related SAM-dependent methyltransferases or enzymes in the NAD+ salvage pathway

For those with certain medical conditionssuch as pernicious anemia or gastrointestinal disorders that impact nutrient absorptionB12 shots are often the most reliable way to maintain healthy levels and support immune function

It highlights the limits of passive surveillance and emphasizes cautious, evidence-based practice

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