Links between CD39 and purinergic mediators with metabolism have been reported before in the context of hepatocellular carcinoma, where Cd39 deficiency was associated with increased production of lactate38; and in liver inflammation, where low CD39 and CD73 levels were noted in combination with upregulated hexokinase 2, pyruvate kinase M2 (PKM2) and lactate dehydrogenase39. The gene discussed is ENTPD1; the disease is hepatocellular carcinoma.