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Nicotinamide N-oxide (NAMO) is a primary metabolite of nicotinamide (vitamin B3) that has demonstrated significant therapeutic potential in preclinical models of sepsis-induced acute liver injury. It acts as a cytoprotective agent by alleviating hepatic inflammation, oxidative stress, and mitochondrial dysfunction. NAMO's mechanism involves the regulation of the SIRT3/AKT signaling pathway, which helps maintain mitochondrial integrity and cellular energy levels. Research shows that NAMO treatment downregulates pro-inflammatory cytokines such as IL-1β, TNF-α, and IL-6, while enhancing the activity of antioxidant enzymes like catalase (CAT) and glutathione (GSH). Additionally, it restores the expression of mitochondrial regulatory factors, including PGC-1α and NRF1, effectively shielding the liver from pathological damage associated with systemic infection.
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