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DTT causes upregulation of the S-adenosylmethionine (SAM)-dependent methyltransferase gene rips-1. On low vitamin B12 diet, DTT leads to the depletion of SAM that results in toxicity. Supplementation of vitamin B12 and methionine attenuates DTT toxicity by restoring SAM levels. Supplementation of choline also rescues DTT toxicity by repleting phosphatidylcholine via an SAM-independent pathway.
