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While the TME is generally ROS-high, basal or moderately elevated ROS levels are crucial for driving and maintaining the pro-tumor M2 phenotype

Due to the interconnection of glycolysis and Oxphos, there is dynamic interchange between cytoplasmic and mitochondrial NAD + , as depletion of cytoplasmic NMNAT2 also depletes mitochondrial NAD + 77

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Figure 2 2.1 Tumor microenvironment and metabolic alteration in malignant cells Cells require macromolecules that support them in growth and division similarly malignant cells also require macromolecules for their development and these macromolecules are synthesized from scratch via rewiring the metabolic pathways inside the cells or may be obtained from other sources, to meet the metabolic demands required for their development and proliferation (37)