NAD+ as a Pharmacological Tool to Boost Sirtuin Activity

Abstract

NAD+ is long known as a redox cofactor, but in recent years also emerged as a substrate for sirtuins, which thereby regulates many cellular activities. The NAD+ levels dictate sirtuin activity and allow this metabolite to integrate metabolic cues into adaptive responses, for instance through inducing mitochondrial biogenesis. With this in mind, strategies to increase the cellular or mitochondrial NAD+ levels were developed as a treatment for metabolic diseases. In this chapter, I will discuss the NAD+ synthesis and breakdown pathways as their combined action determines NAD+ levels. Furthermore, I will outline the pharmacological ways to boost NAD+ levels and treat inherited and acquired metabolic diseases.