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Finally, a few new studies demonstrated that the BNT162b2 vaccine could lead to lengthened germinal center reactions, probably due to Tfh over-response, which might explain the hypermetabolic lymphadenopathy following vaccination (173, 174)

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Its fundamental pharmacological mode of action hinges on selective NNMT suppression: blocking excessive nicotinamide methylation reactions to elevate endogenous intracellular nicotinamide reserves, further accelerating downstream NAD+ biosynthesis