Effect of nicotinamide riboside on airway inflammation in COPD: a randomized, placebo-controlled trial.
Level 2 - randomized trial
Individual randomized controlled trial
PubMed 39548320 · doi:10.1038/s43587-024-00758-1
What was done
A randomized, double-blind, placebo-controlled clinical trial evaluated oral supplementation with the NAD+ precursor nicotinamide riboside (NR) for 6 weeks, followed by a 12-week post-treatment follow-up, in 40 patients with stable chronic obstructive pulmonary disease (COPD). The primary outcome was the change in sputum interleukin-8 (IL-8) from baseline to week 6. Secondary outcomes included whole-blood NAD+ levels and plasma IL-6, along with exploratory analyses of airway genomic integrity pathways and epigenetic aging.
What was found
The estimated treatment difference between NR and placebo in sputum IL-8 after 6 weeks was -52.6% (95% CI: -75.7% to -7.6%; P = 0.030). This reduction persisted 12 weeks after the end of treatment (-63.7%; 95% CI: -85.7% to -7.8%; P = 0.034). NR treatment increased whole-blood NAD+ levels by more than twofold, while plasma IL-6 levels were unchanged. Exploratory analyses indicated upregulation of gene pathways related to genomic integrity in the airways and reduced epigenetic aging.
Why it matters
This trial provides preliminary evidence that replenishing NAD+ via nicotinamide riboside can reduce airway inflammation in stable COPD. It highlights a potential metabolic approach to targeting age-related mechanisms in chronic lung disease.
Limits
The sample size is small (n = 40), leading to wide confidence intervals around the primary estimate. The abstract does not report functional or clinical outcomes such as spirometry (FEV1), exacerbations, quality of life, or safety and tolerability data. The specific dosage of nicotinamide riboside is not stated in the abstract.
Cited by
- supports Eight human randomized controlled trials demonstrate that nicotinamide riboside possesses anti-inflammatory activity, including in COPD patients where it reduced sputum inflammatory markers.
- supports Eight randomized clinical trials have shown beneficial effects of NR in lowering inflammation.