Nicotinamide Riboside Protects Against Doxorubicin-Induced Liver and Kidney Toxicity: Preclinical Findings

Synopsis

Doxorubicin (DOX) is a powerful chemotherapy drug, but its use is limited because it causes serious liver and kidney toxicity through ferroptosis, an iron-dependent form of cell death driven by oxidative stress. This study tested whether nicotinamide riboside (NR)—a vitamin B3–derived NAD+ precursor—could protect against DOX-induced organ injury. In mice treated with DOX, researchers observed severe liver and kidney dysfunction, tissue inflammation, collagen buildup, and high levels of oxidative and iron-related damage. Pretreatment with NR significantly improved hepatic and renal function, lowering markers such as ALT, AST, creatinine, and BUN, while also reducing tissue necrosis and hemorrhage. NR restored antioxidant defenses, including glutathione and glutathione peroxidase, and reduced lipid peroxidation and iron overload. These results show that NR prevents ferroptosis and oxidative stress, protecting vital organs from chemotherapy toxicity. The findings highlight NR’s potential as a protective supplement to reduce DOX-induced side effects and improve the safety of cancer treatment.

Journal

ScienceAsia