“…Excess amino acid leucine inhibits QPRT, which prevents the formation of niacin or NA to nicotinic acid mononucleotide (NAMN) (189). Reduced tryptophan availability, particularly after chronic immune activation or in the absence of a tryptophan-rich diet (i.e., soy, meat, fish, eggs, and peanuts), may also be associated with the development of pellagra (217). Essential differences, however, may be observed between ADC and pellagra, as the latter develops as a result of a global bodily deficiency of tryptophan and niacin, while ADC develops as a result of increased tryptophan and NAD + catabolism at specific, although possibly numerous, sites (Fig.…”