Sirtuins, a family of NAD+-dependent deacetylases, have been reported to modulate circadian control and regulate various autoimmune diseases via epigenetic modification, chromatin remodeling, and other mechanisms.34,35 The increase of intracellular NAD+ levels caused by CD38 deletion directly affects the expression and activity of the sirtuin family of proteins. This evidence concerns the gene CD38 and autoimmune disease.