“…This pathological condition is characterized by the excessive accumulation of extracellular matrix (ECM) proteins, such as collagen, in organs and tissues, leading to organ dysfunction and failure (Henderson et al, 2020 ). Recent studies show that many NAD metabolism enzymes, including NAMPT, sirtuins, PARPs, and CD38, play a key role in ECM remodeling and fibrosis (Huang et al, 2023 ; Shi et al, 2021 ; Wu et al, 2023 ; Xu et al, 2021 ; Zhen et al, 2021 ). CD38, for example, has been linked with the development of pulmonary, renal, and systemic sclerosis through its role in regulating the expression of proinflammatory cytokines, chemokines, and senescence (Cui et al, 2022 ; Shi et al, 2021 ; Tao et al, 2023 ).…”