Nicotinamide Riboside Relieves Airway Inflammation in COPD

TOPLINE:

Nicotinamide riboside (NR) supplementation may reduce airway inflammation and, thereby, lower the risk for exacerbation in patients with noneosinophilic chronic obstructive pulmonary disease (COPD) who smoked previously.

METHODOLOGY:

• The anti-inflammatory effect of NR has been previously documented, and the current study investigated whether its supplementation could reduce airway inflammation in patients with noneosinophilic COPD who smoked previously.
• The researchers conducted a randomized controlled trial involving patients with COPD (n = 40; mean age, 71.9 years) who had an eosinophilic count 9 cells/L and a history of smoking greater than 10 pack-years, as well as control individuals with no history of smoking or lung disease (n = 18; mean age, 70.9 years).
• In each group, patients were randomly assigned to receive either NR (2 g/d) or placebo for 6 weeks, with assessments conducted at pretreatment, posttreatment, and 12-week follow-up visits posttreatment.
• The primary outcome was the effect of NR supplementation on airway inflammation as assessed by changes in the levels of sputum interleukin (IL) 8, which is an essential aggravator of cellular senescence and associated with disease severity in COPD.
• The secondary outcome was the effect of NR supplementation on levels of anti-inflammatory markers, including whole blood nicotinamide adenine dinucleotide (NAD+) and plasma IL-6.

TAKEAWAY:

• Six weeks of NR supplementation vs placebo resulted in a significant reduction in sputum IL-8 levels (estimated treatment difference, −52.6%; P = .030), which persisted until 12 weeks after the end of treatment (estimated treatment difference, −63.7%; P = .034).
• NR supplementation increased NAD+ levels in whole blood by 71.1 μM in patients with COPD and by 49.4 μM in healthy control individuals, with no changes observed with any of the placebo arms. NR treatment had no effect on plasma IL-6 levels.
• Overall, 29 adverse events were reported by 26 participants; however, no differences in adverse events were noted between NR supplementation and placebo in both patients with COPD and control individuals.
• The exploratory analyses showed indications of upregulated gene pathways related to lowered epigenetic aging; however, further studies are needed to confirm these results.

IN PRACTICE:

“Our findings suggest that NR could possibly be a viable treatment option for patients with COPD,” the authors wrote. “We acknowledge that our results need to be confirmed and replicated in longer-term trials with larger sample sizes, applying multiple methods to assess cellular senescence,” they further added.

SOURCE:

The study was led by Kristoffer L. Norheim, Department of Cellular and Molecular Medicine, Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark. It was published online on November 15, 2024, in Nature Aging.

LIMITATIONS:

The major limitation of the study is the small sample size, which resulted in statistical limitations such as large CIs. Another limitation was the inability to perform assessments, including those of other markers of inflammation, due to COVID-19. Last, the short treatment period of 6 weeks limited the ability to detect long-term changes in the severity of COPD symptoms.

DISCLOSURES:

The study was partially funded by the Novo Nordisk Foundation. Two authors declared being employees of Elysium Health (New York) and owning shares in the company. The other authors declared no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.