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These findings suggest that DMF, in addition to NRF2 activation on antioxidant response, could affect L2HGDH expression, L2HG and SAM levels to modify DNA 5mC and 5hmC modifications and CBS expression in SCD erythroblasts

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No clinical trial has tested this combination, but the pharmacological logic supports the approach for researchers operating at the cutting edge

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Morning dosing is generally preferred to align with natural metabolic patterns, though this has not been rigorously studied