Study 2: Selective Small-Molecule Inhibitors (including 5-Amino-1MQ) A selective, membrane-permeable NNMT inhibitor series decreased intracellular 1-MNA, increased NAD and SAM, suppressed adipocyte lipogenesis, and reversed high-fat-diet obesity in mice
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Notably, the observed downregulation of Metallothionein-2 (Mt2) in the serum proteome results, a well-established inducible antioxidant and metal-chelating protein in serum, strongly supports the interpretation of reduced oxidative stress
This typically involves: Intrinsic factor antibodies (highly specific for pernicious anaemia, though sensitivity is only 50%) [12] [28] Gastric parietal cell antibodies (more sensitive but less specific) Coeliac serology if malabsorption is suspected Consideration of upper gastrointestinal endoscopy in selected cases, particularly with autoimmune gastritis/pernicious anaemia NICE guidance emphasises that treatment should not be delayed whilst awaiting antibody results if clinical features strongly suggest deficiency, as irreversible neurological damage can occur
