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NAD+ enhanced mesenchymal stromal cells (NAD+-MSCs) are an experimental cell therapy consisting of mesenchymal stromal cells (MSCs) pretreated with nicotinamide adenine dinucleotide (NAD+). This pretreatment is designed to overcome the limitations of standard MSCs, such as replicative senescence and reduced activity in the host environment. The mechanism involves the promotion of NAMPT (Nicotinamide phosphoribosyltransferase) secretion by the MSCs, which subsequently activates the SIRT1/PGC-1α signaling pathway in target tissues. This activation improves mitochondrial function and fatty acid oxidation, specifically in skeletal muscle. Research indicates that NAD+-MSCs significantly improve muscle strength, endurance, and mass in models of age-related muscle atrophy (sarcopenia) compared to untreated MSCs.
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