 Plafemidone, PFD, is widely used in patients with idiopathic pulmonary fibrosis, IPF, but it can cause nausea and photosensitivity. These side effects are so severe that many patients stop taking the drug altogether. There is no solution for these side effects yet, since the underlying mechanism is not fully understood. Real-world data analysis suggests that PFD may cause palagrolike symptoms, which could explain why some patients experience nausea and photosensitivity. To test this hypothesis, reverse translational experiments were conducted on female BALBC mice. The mice were given either PFD or a placebo, and their responses to niacin and its metabolites were measured. The results showed that PFD caused palagrolike symptoms in the mice, including nausea and photosensitivity. This suggests that PFD may act through nicotinamide n-methyl transferase, NNMT, which is involved in the production of niacin. Higher levels of NNMT substrates were detected in the urine of patients who had taken PFD, suggesting that PFD may increase the. This article was authored by Koji Kuranuma, Natsumi Susai, Tomohiro Koroita, and others. We are article.tv, links in the description below.