The most common cause of PNH are somatic mutations in the X-chromosomal gene PIGA.
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However, also a PNH case with a germline mutation in the autosomal gene PIGT and a second acquired somatic hit has been reported.
cADPR and ADPR are synthesized from NAD+ by the bifunctional ectoenzymes of the CD38 family (also includes the GPI-anchored CD157 and the specific, monofunctional ADP ribosyl cyclase of the mollusc Aplysia).