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The primary theoretical concern is that sustained NAD+ elevation through chronic NNMT inhibition could activate pathways (PARP, SIRT1) that have context-dependent roles in cancer biology NAD+ supports DNA repair and cellular longevity, but also fuels rapidly dividing cells

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Inclusion and exclusion criteria The systematic review protocol was established using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines

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Finally, the results of one randomized controlled trial in 601 patients with common forms of retinitis pigmentosa indicated that supplementation with 400 IU/day of synthetic vitamin E (equivalent to 180 mg/day of RRR --tocopherol) modestly but significantly accelerated the loss of retinal function compared to placebo (123)