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NAD + is also produced through salvage pathways from nicotinamide and nicotinamide riboside precursors, however, people with deficiency or low activity of the GS gene exhibit severe secondary NAD + deficiency (Reference Hu, Ibrahim and Stucki15) , indicating that the glutamine supply is indispensable for NAD + synthesis (Reference Wojcik, Seidle and Bieganowski16)