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ROS are a hallmark of oxidative stress and they can damage intracellular proteins, lipids, and DNA, leading to impairment of cellular function and structure, which has been implicated in the development of a variety of diseases including aging, diabetes mellitus, vascular endothelial cell injury, neurodegenerative diseases, and the onset of cellular senescence, strategies to replenish depleted NAD + pools can offer significant improvements of pathologic states (Klimova and Kristian, 2019

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However, when it comes to clinically applying these strategies, the task of simply boosting NAD + comes with challenges