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One polymorphism indicated that decreased TNF- level (along with decreased IL-1 and IL-6 levels) (rs3804099) was associated with beneficial response

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Buffered NAD+ ships with a pH stabilizer (most commonly Tris) that brings the reconstituted solution closer to physiological pH (~7-8.5), while unbuffered NAD+ reconstitutes acidic (~pH 3-4) and is more often associated with injection-site stinging

The rationale is that their synergistic action may mean you don't need the full dose of either to achieve the desired effect, potentially reducing the total amount of compound needed