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NAD+ also works as a key substrate for several enzyme families: Sirtuins (SIRT1-7) - enzymes that regulate cellular health, DNA repair, and longevity PARPs (poly-ADP-ribose polymerases) - crucial for DNA repair mechanisms CD38 and other NAD+ glycohydrolases - involved in immune function and signaling These pathways allow NAD+ to influence DNA repair, chromatin remodeling, cellular senescence, and immune cell function [4]