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NAD+ biosynthesis enzyme

Molecular classification
Enzyme, Metabolic enzyme, Transferase (specific members: NAMPT, NAPRT, NMNAT, NRK, QAPRTase are transferases), Synthetase
01

Overview

NAD+ biosynthesis enzymes are a group of metabolic enzymes responsible for the production and recycling of nicotinamide adenine dinucleotide (NAD+) within cells. NAD+ is an essential molecule for energy metabolism, acting as an electron carrier in redox reactions, and serving as a co-substrate for key signaling molecules such as sirtuins and PARPs. The main biosynthetic pathways include the de novo route from tryptophan, the Preiss-Handler pathway from nicotinic acid, and the salvage pathway from nicotinamide, as well as recently identified routes using nicotinamide riboside and nicotinamide mononucleotide. Key enzymes include NAMPT, NAPRT, NMNAT, NRK, and QAPRTase. Dysregulation or upregulation of these enzymes is associated with cancer metabolism, age-related diseases, neurodegenerative disorders, and metabolic syndromes. Several drugs are under development or in clinical use targeting these enzymes, particularly to induce cancer cell death and modulate immune responses, but significant challenges remain in minimizing side effects and improving therapeutic selectivity[2][3][4][5][6][1][7].

Other names
NAD biosynthetic enzymeNAD+ synthetasenicotinamide phosphoribosyltransferase (NAMPT)nicotinic acid phosphoribosyltransferase (NAPRT)nicotinamide mononucleotide adenylyltransferase (NMNAT)nicotinamide riboside kinase (NRK)quinolinate phosphoribosyltransferase (QAPRTase)NMRK1/2
02

Mechanism of action

Inhibition of NAD+ biosynthesis (NAMPT inhibitors block the salvage pathway, decrease NAD+ levels, induce apoptosis in cancer cells) [2][3][4][5] - Boosting NAD+ levels (precursor supplementation increases NAD+, activates sirtuins, improves metabolism and longevity, protects against metabolic disease) [6] - Modulation of NAD+-dependent enzyme signaling (such as sirtuins or PARPs) - Interference with NAD+ redox reactions - Disruption of tumor metabolism and immune evasion (targeting NADase or biosynthesis inhibits tumor immunosuppressive microenvironment) [2]

03

Biological functions

NAD+ biosynthesis and recyclingEnergy metabolism (redox reactions/cellular respiration)Substrate provision for sirtuins and PARPs (protein deacetylation, ADP-ribosylation, signaling, DNA repair)Regulator of cell proliferation and cell death (apoptosis)Immune regulation (modulates tumor microenvironment via NAD metabolism)Calcium signaling (via cyclic ADP-ribose)
04

Disease associations

Cancer (tumor metabolism, immunosuppression)Neurodegenerative disease (Alzheimer’s, Parkinson’s, multiple sclerosis)Aging and age-related diseaseMetabolic disorders (type 2 diabetes, mitochondrial diseases)InflammationInfection (target in tuberculosis)
05

Safety considerations

Dose-limiting toxicity for NAMPT inhibitors, such as thrombocytopeniaRescue of normal cell toxicity by co-administration of substrate (e.g., niacin/NA with NAMPT inhibitor)Non-specific toxicity and potential impact on normal metabolism (energy, DNA repair)Need for selectivity to avoid side effects in healthy tissuesLong-term safety of NAD+ boosting agents not fully established
06

Interacting drugs

FK866 (APO866): NAMPT inhibitor

8 more in the full profile.

07

Biomarkers

NAMPT expression (tumor marker, target for NAMPTi)NAD+/NADH ratio (cellular metabolic state, redox balance)NADPH/NADP+ ratio (antioxidant status, measured in cancer and metabolic disease)Sirtuin activity (SIRT1/SIRT3 activation is downstream of NAD+ metabolism)Poly-ADP ribose polymerase (PARP) activation/status

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