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After an injection, NAD+ can take several paths: CD38/CD157 breaks it down into nicotinamide (NAM), which cells can absorb [10] Outside enzymes turn it into nicotinamide mononucleotide (NMN) [10] Special transporters like connexin 43 (Cx43) channels, found mainly in heart muscle cells, let it in [10] These smaller molecules can enter cells where they become NAD+ again through various biological processes

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Preclinical studies document stimulation of collagen and glycosaminoglycan synthesis, upregulation of antioxidant enzymes including superoxide dismutase, and activation of matrix metalloproteinase pathways involved in tissue remodeling and scar resolution