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Age-related NAD+ decline impairs this critical DNA repair pathway CD38 balance: The ectoenzyme CD38 consumes NAD+ and increases with age, creating a vicious cycle of NAD+ depletion and immune dysregulation By restoring NAD+ levels, supplementation recalibrates multiple aging pathways simultaneously: improved DNA repair, enhanced mitochondrial biogenesis, restored epigenetic regulation, activated autophagy, and improved nutrient sensing

The potential mechanisms and clinical trials of small molecules improving poor cell engraftment and repopulation in hepatocyte transplantation were shown in Figure 2

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Drugs 48 , 794847 (1994)