CD38 deficiency suppresses Nrf2 activation by reducing Nox4-induced ROS production, and decreasing the expression of contractile marker calponin, smooth muscle protein 22-α (SM22α) and α-smooth muscle actin (α-SMA), but increasing the expression of the smooth muscle cell dedifferentiation marker, vimentin, enhancing cell proliferation and promoting atherosclerosis [127]. Here, CD38 is linked to atherosclerosis.