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Introduction Cluster of differentiation 38 (CD38) is a cell surface glycoprotein and multifunctional extracellular enzyme which is primarily a NAD + glycohydrolase and ADPR cyclase ( + ) hydrolase, most of the NAD + catalyzed by CD38 is converted to adenosine diphosphate-ribose (ADPR), and a few molecules are cyclized to form cADPR by ADPR cyclase ( + ( As a cell surface receptor, CD38 is necessary for immune cell activation and proliferation