Initial studies demonstrated that NAD+ metabolism may be highly dependent on MAPK-mediated nicotinamide mononucleotide adenylyltransferase 2 (NMNAT2) degradation, thereby promoting axon degeneration [170, 171]; this suggests that ZIKV infection alters cellular metabolism via the MAPK-NMNAT2-NAD+ axis (Fig. 2). Here, NMNAT2 is linked to Zika virus infectious disease.