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This usually results in larger-than-normal red blood cells that are unable to move from the bone marrow into the bloodstream at an appropriate rate (R)

It is not known exactly what causes the disease

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Studies have consistently reported that inhibiting NNMT activity or downregulating NNMT expression leads to significant increases in NAD + levels in mouse adipocytes (Neelakantan et al., 2018) and hepatocytes (Song et al., 2020)