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The decline of NAD + with age results from three converging factors: (1) increased activity of CD38, a NADase whose expression increases with age-related chronic inflammation (inflammaging), (2) reduced biosynthesis via the NAMPT (nicotinamide phosphoribosyltransferase) and NMN pathways, and (3) increased demand for NAD+ by PARP-1 to repair increasing oxidative DNA damage

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Ann N Y Acad Sci 939:162178 Calabrese V, Ravagna A, Colombrita C, Scapagnini G, Guagliano E, Calvani M, Butterfield DA, Giuffrida Stella AM (2005) Acetylcarnitine induces heme oxygenase in rat astrocytes and protects against oxidative stress: involvement of the transcription factor Nrf2