Therapeutic Potential of NAD-Boosting Molecules: The In Vivo Evidence
Open accessAbstract
Nicotinamide adenine dinucleotide (NAD), the cell's hydrogen carrier for redox enzymes, is well known for its role in redox reactions. More recently, it has emerged as a signaling molecule. By modulating NAD+-sensing enzymes, NAD+ controls hundreds of key processes from energy metabolism to cell survival, rising and falling depending on food intake, exercise, and the time of day. NAD+ levels steadily decline with age, resulting in altered metabolism and increased disease susceptibility. Restoration of NAD+ levels in old or diseased animals can promote health and extend lifespan, prompting a search for safe and efficacious NAD-boosting molecules that hold the promise of increasing the body's resilience, not just to one disease, but to many, thereby extending healthy human lifespan.
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NAD+ or NAD precursors can increase healthspan in experimental animals.
“NAD+ or NAD precursors can increase healthspan in experimental animals141.”
From Cellular senescence and senolytics: the path to the clinic (2022) · cites this paper as [141]
NAD+ precursor administration is a simple and convenient strategy to activate NAD+ synthesis and increase NAD+ levels.
“NAD+ precursor administration is a simple and convenient strategy to activate NAD+ synthesis and increase NAD+ levels (9).”
From Nicotinamide riboside and nicotinamide mononucleotide facilitate NAD <sup>+</sup> synthesis via enterohepatic circulation (2025) · cites this paper as [9]
NR and NMN have a protective effect in a number of age-related disease models, by increasing the pool of precursors and thus NAD+ levels in the body.
“According to reports, NR and NMN have a protective effect in a number of age-related disease models, by increasing the pool of precursors and thus NAD+ levels in the body, both of which have been tested in murine and invertebrate aging studies [195, 197, 199].”
From Immunosenescence: a key player in cancer development (2020) · cites this paper as [195]
NAD+ declines in many tissues during the aging process, including adipose tissue, skeletal muscle, brain, liver, pancreas, heart, spleen, kidney, and lungs, leading to various age-related pathophysiology developments.
“Much of the literature suggests that NAD+ declines in many tissues during the aging process, including adipose tissue, skeletal muscle, brain, liver, pancreas, heart, spleen, kidney, and lungs, leading to various age-related pathophysiology developments [195–197].”
From Immunosenescence: a key player in cancer development (2020) · cites this paper as [195]
Systematic NAD+ decline and decreased sirtuin activity are considered molecular events of ageing that may underlie the increase in age-related diseases limiting lifespan.
“Systematic NAD+ decline and decreased sirtuin activity are considered among the molecular events that occur during ageing, possibly underlying the increase in age-related diseases that limit organismal lifespan251.”
From Mitochondrial and metabolic dysfunction in ageing and age-related diseases (2022) · cites this paper as [251]
NAD+ decline during aging is well documented in preclinical models and has recently emerged in humans where skin and brain NAD+ decreases across the lifespan.
“NAD+ decline during aging is well documented in preclinical models and has recently emerged in humans where skin and brain NAD+ decreases across the lifespan46.”
From Mitochondrial oxidative capacity and NAD+ biosynthesis are reduced in human sarcopenia across ethnicities (2019) · cites this paper as [46]
NAD+ precursor interventions are safe and increase NAD+ levels in early human clinical testing.
“the demonstration that these interventions are safe and increase NAD+ levels in early human clinical testing46,55,56”
From Mitochondrial oxidative capacity and NAD+ biosynthesis are reduced in human sarcopenia across ethnicities (2019) · cites this paper as [46]
Conversion of NAD+ precursors (NR or NMN) to NAD+ bypasses the rate-limited enzyme NAMPT.
“the conversion of these precursors to NAD+ bypasses the rate limited enzyme NAMPT”
From Mitochondrial oxidative capacity and NAD+ biosynthesis are reduced in human sarcopenia across ethnicities (2019) · cites this paper as [46]
New therapeutic strategies have emerged to restore NAD+ levels in muscle by administration of dietary NAD+ precursors such as NR or NMN.
“new therapeutic strategies have emerged to restore NAD+ levels in muscle by administration of dietary NAD+ precursors such as NR or NMN46,53,54”
From Mitochondrial oxidative capacity and NAD+ biosynthesis are reduced in human sarcopenia across ethnicities (2019) · cites this paper as [46]
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“Extracellularly, NAD+ is cleaved to NMN and AMP by nucleotide pyrophosphatases including CD73 (Aleo et al., 2001; Grozio et al., 2013), while the transmembrane glycohydrolases CD38 and CD157 cleave NAD+ to generate NAM and ADPR and can also act as ADP-ribosyl cyclases that catalyze the hydrolysis of NAD+ to generate N…”
InfluentialMetabolic Profiling of Alternative NAD Biosynthetic Routes in Mouse Tissues
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Cellular senescence and senolytics: the path to the clinic
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Mitochondrial and metabolic dysfunction in ageing and age-related diseases
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Self-citationNAD+ homeostasis in health and disease
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Immunosenescence: a key player in cancer development
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The quest to slow ageing through drug discovery
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Extracellular vesicle-contained eNAMPT delays aging and extends lifespan in mice
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Slc12a8 is a nicotinamide mononucleotide transporter
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NAD metabolism: Implications in aging and longevity
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Bacteria Boost Mammalian Host NAD Metabolism by Engaging the Deamidated Biosynthesis Pathway
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Metformin Is a Direct SIRT1-Activating Compound: Computational Modeling and Experimental Validation
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Caloric Restriction Mimetics in Nutrition and Clinical Trials
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Healthy aging and muscle function are positively associated with NAD+ abundance in humans
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NAD+ in COVID-19 and viral infections
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Moderate Exercise Inhibits Age-Related Inflammation, Liver Steatosis, Senescence, and Tumorigenesis
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“Elevating NAD levels has been reported to have major therapeutic implications for metabolism and aging (41).”
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“Recently, nicotinamide riboside (NR) and nicotinamide mononucleotide (NMN) have attracted increasing interest as alternative NAD + precursors ( 4 , 9 ).”
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Importance of Adipose Tissue NAD+ Biology in Regulating Metabolic Flexibility
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The significance of caloric restriction mimetics as anti-aging drugs
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- Authors
- Rajman, L., Chwalek, K., & Sinclair, D. A.
- Affiliations
- Harvard University (US)
- Corresponding author
- Sinclair, David A.
- Venue
- Cell Metabolism
- Publisher
- Elsevier BV
- Published
- 2018-03
- Volume
- 27
- Issue
- 3
- Pages
- 529-547
- ISSN
- 1550-4131 (ISSN-L)
- PMC
- PMC6342515
- OpenAlex
- W2791758888
- Cited by
- 865
- References
- 270
- Citations by year
- 2026: 81 · 2025: 105 · 2024: 132 · 2023: 113 · 2022: 122 · 2021: 123 · 2020: 106 · 2019: 56 · 2018: 25
- FWCI
- 8.63
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Cell Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (DP1AG058605, R37AG028730, R01AG019719)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK100263)
- Topics
- Health Sciences › Medicine › Geriatrics and Gerontology › Sirtuins and Resveratrol in Medicine
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Biochemical and Molecular Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Aging › Genetics, Aging, and Longevity in Model Organisms
- Keywords
- NAD+, NAD+ precursors, aging, lifespan extension, healthy aging, in vivo evidence, metabolic resilience
- MeSH terms
- Animals, Energy Metabolism, Humans, Longevity, NAD, Signal Transduction
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