Nicotinamide Riboside Protects Against Myocardial Ischemia/Reperfusion Injury: Preclinical Findings

Synopsis

Myocardial ischemia-reperfusion (I/R) injury—tissue damage caused when blood flow returns to the heart after a period of oxygen deprivation—can worsen heart attacks and lead to lasting cardiac dysfunction. This study investigated the independent protective effects of nicotinamide riboside (NR), a vitamin B3–derived NAD+ precursor, on I/R injury in mice and heart cells. NR supplementation reduced heart tissue damage, lowered inflammatory cell infiltration, and decreased oxidative stress markers, such as reactive oxygen species (ROS) and creatine kinase (CK-MB), while improving heart function. In heart muscle cells exposed to low oxygen followed by reoxygenation, NR increased cell survival, decreased oxidative stress, and restored NAD+ levels. Mechanistically, NR activated the SIRT1 pathway, which reduced harmful autophagy (self-degradation of cellular components) and helped protect cardiac cells. Blocking SIRT1 reversed NR’s effects on autophagy but not on ROS, suggesting that NR protects the heart through NAD+-SIRT1–mediated regulation of autophagy, independent of its antioxidant effects.

Journal

Experimental and Therapeutic Medicine