Nicotinamide Riboside Prevents and Reverses Chemotherapy-Induced Peripheral Neuropathy: Preclinical Findings
Synopsis
Damage to sensory nerves can cause peripheral neuropathy after chemotherapy. Increasing levels of nicotinamide adenine dinucleotide (NAD+) can protect nerves from injury. This study tested whether nicotinamide riboside (NR), a form of vitamin B3 and a precursor to NAD+, reduces nerve pain and sensitivity in a rat model of paclitaxel-induced peripheral neuropathy. Daily oral NR given before and during paclitaxel treatment prevented the development of nerve pain and reduced avoidance behaviors, with effects lasting after treatment stopped. NR raised blood NAD+ levels by 50%, did not affect paclitaxel's side effects on blood cells, and caused no movement problems. NR treatment after neuropathy started reversed symptoms in some rats. Acetyl-L-carnitine (ALCAR) did not prevent symptoms and caused nerve pain when given alone. These results suggest NR and other NAD-boosting agents could be a safe, effective treatment for chemotherapy-related nerve damage.
Journal
PAIN