NAD+ repletion improves mitochondrial and stem cell function and enhances life span in mice

Adult stem cells (SCs) are essential for tissue maintenance and regeneration yet are susceptible to senescence during aging. We demonstrate the importance of the amount of the oxidized form of cellular nicotinamide adenine dinucleotide (NAD(+)) and its impact on mitochondrial activity as a pivotal switch to modulate muscle SC (MuSC) senescence. Treatment with the NAD(+) precursor nicotinamide riboside (NR) induced the mitochondrial unfolded protein response (UPR(mt)) and synthesis of prohibitin proteins, and this rejuvenated MuSCs in aged mice. NR also prevented MuSC senescence in the Mdx mouse model of muscular dystrophy. We furthermore demonstrate that NR delays senescence of neural SCs (NSCs) and melanocyte SCs (McSCs), and increased mouse lifespan. Strategies that conserve cellular NAD(+) may reprogram dysfunctional SCs and improve lifespan in mammals.

Metabolic control of muscle and muscle stem cell function

Hongbo Zhang

Skeletal muscle composed of myofibers and a small amount of muscle stem cells (MuSCs). It plays important roles in energy metabolism. Some of the key metabolites, such as NAD+ and acetyl-CoA were recently found to regulate muscle and MuSCs function. Most of these functions are related to the cellular mitochondria. In my PhD thesis projects, we aimed at exploring the link between NAD+ levels, mitochondrial function, muscle structural homeostasis and MuSCs senescence. We also investigated the impact of acetyl-CoA on MuSCs activation and proliferation, through the control of protein acetylation. These projects mainly focus on three aspects: Rejuvenation of adult stem cells by NAD+ repletion. Aging is accompanied by SCs senescence. However, the initial signaling events mediating SCs senescence are still not well defined. We demonstrate the importance of mitochondrial activity as a pivotal modulator of MuSCs senescence. MuSCs from aged mice have reduced NAD+ levels, mitochondrial content and capacity for oxidative respiration. Importantly, the induction of the mitochondrial unfolded protein response (UPRmt), subsequent to increasing cellular NAD+ with the precursor nicotinamide riboside (NR), prevents MuSCs senescence and improves muscle function and regeneration in aged mice. NR also prevents MuSCs dysfunction in the mdx mouse, a known mouse model of accelerated MuSCs senescence. Extending these observations to other SC pools and on the organism as a whole, we demonstrate that NR delays neural and melanocyte SCs senescence, while also increasing mouse lifespan. Control of MuSCs function by acetyltransferase KAT2A. MuSCs are essential for skeletal muscle homeostasis and repair. The complete mechanism controlling MuSCs maintenance and differentiation, however, remains elusive. We found that the acetyltransferase KAT2A expression is essential for myogenic differentiation of MuSCs. KAT2A loss-of-function in cells blocks MuSCs differentiation, and in mice impairs muscle regeneration after damage. The regulation of KAT2A in MuSCs function might rely on its ability to enzymatically acetylate other proteins, and in particular the transcription factor PAX7. NAD+ repletion improves muscle function in muscular dystrophy. Duchenne muscular dystrophy (DMD) is caused by dystrophin gene mutations that lead to progressive muscle degeneration. Our bioinformatics analysis in mice and DMD patients suggests a role for NAD+ in protecting the muscle from metabolic and structural degeneration. Validating these findings, we reveal that the mdx mouse is characterized by reductions in muscle NAD+ levels, concurrent to increased PARP activity and reduced expression of nicotinamide phosphoribosyltransferase (NAMPT), the key enzymes for NAD+ consumption and biosynthesis. Replenishing the NAD+ pool by dietary NR supplementation benefits muscle function in mdx and mdx/Utr-/- mice, an effect replicated in C. elegans models of DMD. The beneficial effects of NAD+ repletion in muscular dystrophy are pleiotropic and rely on the improvement in mitochondrial function, structural protein expression and on reductions in general PARylation, inflammation and fibrosis. In summary, our work demonstrates the critical role of NAD+ and Acetyl-coA in maintaining muscle and MuSCs function. Repletion of NAD+ levels, by NR administration, and/or boosting the function of acetyltransferase KAT2A might be attractive strategies to maintain muscle homeostasis and MuSCs function in aging and muscular dystrophy.

EPFL2016

Effective treatment of mitochondrial myopathy by nicotinamide riboside, a vitamin B3

Johan Auwerx, Eija Riitta Pirinen

Nutrient availability is the major regulator of life and reproduction, and a complex cellular signaling network has evolved to adapt organisms to fasting. These sensor pathways monitor cellular energy metabolism, especially mitochondrial ATP production and NAD+/NADH ratio, as major signals for nutritional state. We hypothesized that these signals would be modified by mitochondrial respiratory chain disease, because of inefficient NADH utilization and ATP production. Oral administration of nicotinamide riboside (NR), a vitamin B3 and NAD+ precursor, was previously shown to boost NAD+ levels in mice and to induce mitochondrial biogenesis. Here, we treated mitochondrial myopathy mice with NR. This vitamin effectively delayed early- and late-stage disease progression, by robustly inducing mitochondrial biogenesis in skeletal muscle and brown adipose tissue, preventing mitochondrial ultrastructure abnormalities and mtDNA deletion formation. NR further stimulated mitochondrial unfolded protein response, suggesting its protective role in mitochondrial disease. These results indicate that NR and strategies boosting NAD+ levels are a promising treatment strategy for mitochondrial myopathy.

Wiley Open Access2014

NAD(+) repletion improves muscle function in muscular dystrophy and counters global PARylation

Johan Auwerx, Carlos Canto Alvarez, Karim Laurent Gariani, Keir Joe Menzies, Laurent Mouchiroud, Dongryeol Ryu, Vincenzo Sorrentino, Xu Wang, Hongbo Zhang

Neuromuscular diseases are often caused by inherited mutations that lead to progressive skeletal muscle weakness and degeneration. In diverse populations of normal healthy mice, we observed correlations between the abundance of mRNA transcripts related to mitochondrial biogenesis, the dystrophin-sarcoglycan complex, and nicotinamide adenine dinucleotide (NAD(+)) synthesis, consistent with a potential role for the essential cofactor NAD(+) in protecting muscle from metabolic and structural degeneration. Furthermore, the skeletal muscle transcriptomes of patients with Duchene's muscular dystrophy (DMD) and other muscle diseases were enriched for various poly[adenosine 5'-diphosphate (ADP)-ribose] polymerases (PARPs) and for nicotinamide N-methyltransferase (NNMT), enzymes that are major consumers of NAD(+) and are involved in pleiotropic events, including inflammation. In the mdx mouse model of DMD, we observed significant reductions in muscle NAD(+) levels, concurrent increases in PARP activity, and reduced expression of nicotinamide phosphoribosyltransferase (NAMPT), the rate-limiting enzyme for NAD+ biosynthesis. Replenishing NAD(+) stores with dietary nicotinamide riboside supplementation improved muscle function and heart pathology in mdx and mdx/Utr(-/-)mice and reversed pathology in Caenorhabditis elegans models of DMD. The effects of NAD(+) repletion in mdx mice relied on the improvement in mitochondrial function and structural protein expression (alpha-dystrobrevin and delta-sarcoglycan) and on the reductions in general poly(ADP)-ribosylation, inflammation, and fibrosis. In combination, these studies suggest that the replenishment of NAD(+) may benefit patients with muscular dystrophies or other neuromuscular degenerative conditions characterized by the PARP/NNMT gene expression signatures.