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3.3 Downstream Signaling Effects Beyond actin sequestration, TB-500 influences several additional signaling pathways: Angiogenic Signaling through CD44 Interaction TB-500 binds to the CD44 cell surface receptor, activating downstream signaling cascades that include: MAPK/ERK pathway: Promotes endothelial cell proliferation PI3K/Akt pathway: Supports cell survival and migration MMP induction: Matrix metalloproteinase activation for extracellular matrix remodeling Integrin-Mediated Cell Adhesion The peptide upregulates integrin expression including v3 and 51, enhancing cell-matrix adhesion and facilitating cell migration across extracellular matrix substrates

Human data on IV NAD+ suggests it can be rapidly removed from plasma during infusion and metabolized into other compounds

van den Oever IAM, Baniaamam M, Simsek S et al (2021) The effect of anti-TNF treatment on body composition and insulin resistance in patients with rheumatoid arthritis

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