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GCL is in part regulated by GSH feedback inhibition, thus if GSH is depleted due to oxidative stress, inflammation, or exposure to xenobiotics, de novo synthesis of GSH is upregulated, as is cysteine synthesis

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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