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showed that upregulation of surface CD38 leads to intracellular NAD + depletion, which induces mitochondrial alterations and increases oxidative stress ( + precursors appears to improve NAD+ levels, acting as adjuvants to boost T lymphocyte responses ( CD38 primarily functions as a NAD+-glycohydrolase ( 2.3.3 CD38 as an immune checkpoint in therapy Based on this understanding, it is speculated that CD38 serves as an immune checkpoint regulating NAD + and ADO homeostasis

Takei A, Fukazawa T, Hamada T, Sohma H, Yabe I, Sasaki H, et al

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Further support was provided by the Uehara Memorial Foundation, Kanae Foundation for the Promotion of Medical Science, Mochida Memorial Foundation for Medical and Pharmaceutical Research and the Human Frontier Science Program, plus the Medical Scientist Training Program and Pharmacology Training Grant at UC San Diego (T32GM007752)