Nicotinamide adenine dinucleotide (NAD ?) is a vital molecule found in all living cells. NAD ? intracellular levels are dictated by its synthesis, using the de novo and/or salvage pathway, and through its catabolic use as co-enzyme or co-substrate. The regulation of NAD ? metabolism has proven to be an adequate drug target for several diseases, including cancer, neurodegenerative or inflammatory diseases. Increasing interest has been given to NAD ? metabolism during innate and adaptive immune responses suggesting that its modulation could also be relevant during host-pathogen interactions. While the maintenance of NAD ? homeostatic levels assures an adequate environment for host cell survival and proliferation, fluctuations in NAD ? or biosynthetic precursors bioavailability have been described during host-pathogen interactions, which will interfere with pathogen persistence or clearance. Here, we review the double-edged sword of NAD ? metabolism during host-pathogen interactions emphasizing its potential for treatment of infectious diseases. Keywords Nicotinamide adenine dinucleotide (NAD ?) Á Host-pathogen interaction Á NAD ? /NADH ratio Á NADPH Á Sirtuins Á L-tryptophan Nicotinamide adenine dinucleotide (NAD ?) was initially discovered by Sir Arthur Harden as a 'cozymase' for yeast fermentation over 100 years ago. The succeeding work contributed to the identification of NAD ? as a player in hundreds of biochemical reactions through its role in redox reactions. NAD ? is either consumed as a co-substrate by NAD ?-consuming enzymes or used as an electron carrier in redox reactions. Yet, the intracellular NAD ? /NADH ratio is key to the maintenance of an adequate metabolic status and cell survival. Growing evidences indicate that NAD ? biosynthetic pathways and metabolism are playing a major role in hostpathogen interactions. In this review, we overview these mechanisms highlighting the role of NAD ? metabolism as an attractive therapeutic target for microbe infections. NAD 1 biosynthesis: where the tale begins NAD 1 biosynthesis in mammalian cells The biosynthesis of NAD ? in mammals occurs through two different pathways: the de novo and the salvage pathways (Fig. 1). The de novo pathway begins with the uptake and conversion of dietary L-tryptophan in N-formylkynurenine, which is mediated by the rate-limiting indoleamine 2,3-dioxygenase (IDO) or tryptophan 2,3