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Besides serving as a substrate for CD38, NAD + may also function as a cytokine, eliciting rapid functional responses mediated by specific purinergic type 2 (P2) receptors ( The products of NAD + disassembly mediated by extracellular CD38, namely ADPR and NAM, may undergo further metabolic transformations [(e.g., to adenosine monophosphate (AMP) or adenosine (ADO)], particularly when co-expressed with other ectonucleotidases in certain pathological environments, such as the bone marrow (BM) niche ( + (NADP + ) as a substrate and, in the presence of CD203a and CD73 under low pH conditions, produce ADO as a final product ( A key question is whether the products of the CD38-dependent chain of ectoenzymes play a role in physiology and especially in pathology

10.1016/j.coi.2017.07.015 128 PagliariS.DemaB.Sanchez-MartinezA.Montalvo Zurbia-FloresG.RollierC

It enhances energy levels, improves metabolic function, and supports nervous system health

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Side effects Topiramate can cause stomach pain, nausea, diarrhea, anorexia, and problems with taste