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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