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A translational review on NNMT inhibitor clinical development ( Emerging opportunities for NNMT inhibitor clinical translation , ScienceDirect, 2026) points out that alternative routes like polyamine biosynthesis could compensate for the raised SAM, and that partial rather than total inhibition might even be preferable specifically to avoid triggering those compensatory mechanisms from a chronically imbalanced SAM/SAH ratio

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This initial step is crucial and can be impaired in individuals with reduced gastric acid production, such as older adults or those taking proton pump inhibitors (PPIs) or H2-receptor antagonists

Effective across multiple GI pathology models including ulcers, fistulas, and inflammatory bowel disease No reported toxicity even at high doses in preclinical studies Mechanism involves interaction with NO system, dopamine system, and prostaglandin pathways The promoting effect of pentadecapeptide BPC 157 on tendon healing involves tendon outgrowth, cell survival, and cell migration2011Tissue Repair BPC 157 accelerates healing of transected rat Achilles tendon and stimulates tendocyte growth in vitro