Ectoenzymes And Their Products As Communicators In The Human Myeloma Niche

Development of human multiple myeloma (MM) in the bone niche derives from multiple factors. Besides cells and soluble factors, hypoxia triggers anaerobic glycolysis, reduces ATP and simultaneously increases NAD+. This condition likely influences the ectoenzymatic pathways working in the niche. ATP is the substrate for the CD39/CD73 pathway leading to adenosine (Ado) production. NAD+ activates an alternative pathway, where Ado is obtained by the articulated actions of the CD38/CD203a/CD73 axis.