NAD+ is a vital coenzyme involved in numerous biological processes, including energy metabolism, DNA repair, and cell signaling, with emerging potential in pain management and tissue regeneration.
Why it Matters:
NAD+ matters in pain management because it can reduce inflammation, oxidative stress, and promote neuronal repair, offering effective relief for chronic pain.
Nicotinamide adenine dinucleotide (NAD+) is emerging as a promising player in the realm of pain management and tissue regrowth, offering new avenues for regenerative medicine. NAD+ is a coenzyme found in all living cells, playing a critical role in various biological processes, including energy metabolism, DNA repair, and cell signaling [1].
NAD+ is a crucial molecule involved in redox reactions within the cell, serving as a carrier of electrons during metabolic processes. Its role as a coenzyme is essential for the functioning of enzymes involved in various metabolic pathways, including glycolysis, the citric acid cycle, and oxidative phosphorylation. Additionally, NAD+ is a substrate for enzymes such as sirtuins, which play key roles in regulating cellular processes such as gene expression, DNA repair, and apoptosis [2].
Chronic pain is a debilitating condition affecting millions worldwide, often challenging to manage with conventional therapies. NAD+ therapy has shown promise in mitigating pain by modulating inflammatory pathways, reducing oxidative stress, and enhancing mitochondrial function. Studies have demonstrated that NAD+ supplementation can alleviate neuropathic pain by promoting neuronal repair and reducing inflammation in animal models [3]. Furthermore, NAD+ has been found to enhance the production of neurotransmitters involved in pain modulation, offering a multifaceted approach to pain management [4].
NAD+ can be harvested from natural sources or synthesized in the laboratory. One common method involves extraction from yeast or bacteria cultures rich in NAD+ precursors such as niacin (vitamin B3). Alternatively, NAD+ can be chemically synthesized using precursor molecules. In clinical settings, NAD+ therapy is typically administered intravenously, allowing for rapid absorption and distribution throughout the body. Intravenous infusion ensures precise dosing and optimal bioavailability, maximizing the therapeutic effects of NAD+ [5].
Several clinical studies have investigated the efficacy of NAD+ therapy in pain management and tissue regeneration. A randomized controlled trial involving patients with diabetic neuropathy demonstrated significant improvements in pain scores and nerve function following intravenous NAD+ infusion compared to placebo [6]. Similarly, a pilot study in individuals with fibromyalgia reported reductions in pain severity and improved quality of life after NAD+ treatment [7]. Moreover, preclinical studies have shown promising results in promoting tissue regeneration, particularly in wound healing and musculoskeletal injuries [8].
The regenerative medicine field is increasingly exploring the therapeutic potential of NAD+ in promoting tissue repair and regeneration. By enhancing cellular metabolism and activating pathways involved in tissue growth, NAD+ holds promise for accelerating wound healing, cartilage regeneration, and bone repair. Furthermore, NAD+ therapy may complement existing regenerative strategies such as stem cell therapy by providing a supportive microenvironment for cell proliferation and differentiation.
In conclusion, NAD+ emerges as a versatile tool in pain management and tissue regrowth, offering novel approaches to address chronic pain and promote healing. Harnessing the therapeutic potential of NAD+ holds immense promise for improving patient outcomes in various clinical scenarios. As research continues to unravel the intricate mechanisms underlying its effects, NAD+ therapy is poised to revolutionize the landscape of regenerative medicine, ushering in a new era of healing and restoration.
Written by: Joey Fio, Chief Programs Officer
[1] Verdin, E. (2015). NAD⁺ in aging, metabolism, and neurodegeneration. Science, 350(6265), 1208-1213.
[2] Garten, A., Schuster, S., Penke, M., Gorski, T., de Giorgis, T., Kiess, W., & Ziegler, M. (2015). Physiological and pathophysiological roles of NAMPT and NAD metabolism. Nature Reviews Endocrinology, 11(9), 535-546.
[3] Hamity MV, White SR, Walder RY, Schmidt MS, Brenner C, Hammond DL. Nicotinamide riboside, a form of vitamin B3 and NAD+ precursor, relieves the nociceptive and aversive dimensions of paclitaxel-induced peripheral neuropathy in female rats. Pain. 2017;158(5):962-972.
[4] Okuma Y, Liu Y, Hijikuro I, Jeevithan E, Takeda Y, Yasuda N. Evaluation of the effect of nicotinamide on streptozotocin-induced diabetic neuropathy and nociception in rats. Int J Mol Med. 2017;39(1):214-222.
[5] Trammell SA, Schmidt MS, Weidemann BJ, et al. Nicotinamide riboside is uniquely and orally bioavailable in mice and humans. Nat Commun. 2016;7:12948.
[6] Braidy N, Berg J, Clement J, et al. Role of Nicotinamide Adenine Dinucleotide and Related Precursors as Therapeutic Targets for Age-Related Degenerative Diseases: Rationale, Biochemistry, Pharmacokinetics, and Outcomes. Antioxid Redox Signal. 2019;30(2):251-294.
[7] Zhang H, Ryu D, Wu Y, et al. NAD⁺ repletion improves mitochondrial and stem cell function and enhances life span in mice. Science. 2016;352(6292):1436-1443.
[8] ClinicalTrials.gov [Internet]. Bethesda (MD): National Library of Medicine (US). 2000 Feb 29 -. Identifier NCT01228357, NAD+ Therapy for Fibromyalgia; 2010 Nov 1 [cited 2024 Feb 17]. Available from: https://clinicaltrials.gov/ct2/show/NCT01228357
NAD+ presents a compelling option for general pain relief, not only enhancing overall well-being but also facilitating detoxification within the body. For a comprehensive approach, we suggest combining NAD+ therapy with localized treatments such as stem cells or exosomes, which target specific areas for enhanced efficacy in pain management and tissue regeneration.