TL/DR: Nearly all the in vivo work on nicotinamide riboside and nicotinamide mononucleotide has been done using C57BL/6J mice, a substrain of the widely-used C57BL/6 strain that carries the C57BL/6J NNT mutation. This fact may mean that most or all of the very promising rodent data we've seen — particularly on outcomes involving metabolic health, oxidative stress, or exercise performance — are actually showing only that these nutrients help to compensate for the deleterious effects of this mutation: animals that don't carry such a mutation — including most other rodents and (importantly) humans — will not get similar benefits, because there's no defect there to compensate.
My posts on this are scattered in bits and pieces in the [Curated] thread, so I'm putting it all together in a more coherent and easily-citable post here.
The mitochondrial NAD(P) transhydrogenase (NNT) gene encodes a protein that is embedded in the inner mitochondrial membrane and transfers reducing equivalents between NADH in the cytosol and NADP(+) in the mitochondrial matrix. There, it provides the reducing power needed to detoxify reactive oxygen species (ROS) generated in the mitochondria, both directly and by regenerating thioredoxin and glutathione: it's necessary to maintain redox homeostasis and efficient ATP synthesis in every single cell in the body. "NNT expression differs between cell types, being highest in the heart and kidney. Approximately half of the mitochondrial NADPH in the brain is believed to depend on the action of the NNT, and its inhibition causes significant oxidative stress."(1)
The C57BL/6J mouse strain carries a mutation in this gene, which in turn impairs the function of this protein. Accordingly, C57BL/6J mice exhibit abnormalities in oxidative stress, impaired first-phase insulin secretion following a glucose challenge, and impaired glucose tolerance, and also alters its tendency to weight gain under different diets. And it does a lot of other less-than-obvious things as well:
The key role of the NNT and the network of interactions taking place in cytosolic glucose metabolism highlight that the pathways involved in maintenance of the NAD and NADP pools in their separate redox states are highly interconnected. Indeed, in addition to the malate-asparate and citrate-α-ketoglutarate shuttles providing separate transmission of NAD and NADP redox state between cytosol and mitochondria, a pyruvate-malate shuttle in which the redox state of the cytosolic NADP pool is coupled to that of the mitochondrial NAD pool has also been observed {109}.
Additional complexity in these redox networks also arises from the reversibility of a number of the reactions. For example, during ischaemia, the citric acid cycle may reverse and consume NADH {39}, the NNT may oxidise NADPH to produce NADH when the membrane potential is collapsed {104} or lactate dehydrogenase may reverse, using lactate as a metabolic substrate, producing NADH in the cytosol alongside pyruvate for aerobic ATP production {110}. Indeed, it has been suggested that lactate secreted by astrocytes may serve as the primary energy source for neurons in the brain {111}. Thus, the highly contrasting intracellular roles of the NAD and NADP pools and their separate redox states are supported by a complex and interconnected network of pathways.
Because of all of this, when you knock out the mitochondrial form of SOD, most mouse strains use NNT to partially make up for it; because they lack functional NNT, giving C57Bl/6J the same MnSOD mutation leads to much more severe effects. The more you then back-cross them with strains of mouse with functional NNT, the more they're able to cope with the MnSOD mutation:
congenic Sod2−/− mice on a C57BL/6J background (B6 Sod2−/−) develop a fetal form of dilated cardiomyopathy, and most of them die about day 15 (ED15) of gestation. On the other hand, Sod2−/− mice generated on a DBA/2J (D2 Sod2−/−) background develop normally through gestation and do not have dilated cardiomyopathy. However, these mice develop severe metabolic acidosis and have an average lifespan of 8 days. F1 mice (B6D2F1 Sod2−/−) generated from the two parental strains have a cardiac phenotype similar to that of D2 Sod2−/− mice, but with a milder form of metabolic acidosis. Consequently, these mice are able to survive for up to three weeks without any pharmacological intervention (13). Consistent with our observation, a different Sod2 mutant strain (SOD2m1BCM) generated on a B6/129 mixed genetic background was shown to survive for up to 3 weeks after birth and had a phenotype similar to that of B6D2F1 Sod2−/−tm1Cje (14).(2)
After a series of exciting-looking reports of megadose NR or NMN supplementation in mice, a new study(3) carried out in a different C57BL substrain that does not carry the NNT mutation(3) came as a great surprise. In a previous study,(4) Cantó and Auwerx had shown that megadose NR improved exercise performance and metabolic flexibility (ie, the ability to switch between fatty acids and glucose as fuel in response to changes in fuel availability) in C57BL6J mice. In this newer study,(3) they provided NR as the sole source of vitamin B3 across a wide range of doses (either 5, 15, 30, 180 or 900 mg NR per kg diet) plus the mouse "RDA" of tryptophan, because mammals can synthesize B3 from Trp, to see which dose would give the animals the best metabolic flexibility.
Surprisingly, these guys found that metabolic flexibility is maxed out at 2 x the mouse "RDA" of B3 as NR, and may even get worse when NR is administered at the megadose levels used in previous studies. Fasting metabolic flexibility, maxΔRERCHO1→FAO, was better at 30 mg/kg than at higher or lower doses, although only statistically significantly better as compared to 5NR; "Refeeding metabolic flexibility, maxΔRERFAO→CHO2, was significantly greater in 30NR than in 5NR, 15NR, or 900NR ... No differences were seen in blood glucose, serum TG or NEFA among NR doses (Fig. 3A-C). Serum insulin, leptin, adiponectin, leptin/adiponectin ratio and HOMA-IR index exhibited a tendency towards a dose-response curve, without reaching statistical significance (Fig. 3D-H). In all cases, except adiponectin which shows opposite behaviour, the measured value decreased and then increased, with 30NR being the turning point" — that is, the dose-response curve on markers of insulin resistance were U-shaped, with the nominal insulin resistance lowest at 30 NR and then rising again at higher doses. The suggestion in the trend is that mice given high-dose NR forced their pancreases to pump out more insulin just to maintain the same glucose level.(3)
This is in stark contrast to Cantó and Auwerx, (4) who found megadose NR to improve metabolic flexibility over and above the 30 mg/kg diet of vitamin B3 (as nicotinamide) in the background diet — and the similar findings with NMN in age- and obesity-related diabetes, again in C57BL/6J mice.(10)
Because nearly all the in vivo work on NR and NMN has been done using C57BL/6J mice, most or all of the very promising rodent data we've seen — particularly on outcomes involving metabolic health, oxidative stress, or exercise performance — may actually showing only that NR and NMN help to compensate for the fact that the mutation impairs their ability to transfer reducing equivalents from NADH to NADP+ in the mitochondria. The same applies to the core of the muscle stem cell and lifespan study in Science;(5)* the report that "Long-Term Administration of Nicotinamide Mononucleotide Mitigates Age-Associated Physiological Decline in Mice;"(6) the Sinclair study on NMN restoring more youthful muscle bioenergetics in aging mice that initially got people excited around NR (on the assumption that it would have similar effects);(7) the Sinclair study on NMN restoring PARP1 DNA repair in aging mouse liver;(8) the finding that NMN protected against age- and obesity-related diabetes(10) and a mouse model of Alzheimer's disease;(11) etc etc.
This would in turn predict that contrast, animals that don't carry such a mutation — including the strain of mouse used in (3), most other rodents, and (most importantly) humans — will not get similar benefits, because there's no defect there to compensate. Indeed, in such an organism, increasing the level of NAD+ via megadose NR might instead disrupt optimal NADP:NADPH redox coupling, leading to functional impairments. Consistent with this, "The NAD+ precursor nicotinamide riboside decreases exercise performance in rats,"(9) even though it's been reported to improve exercise performance mice in Canto and Auwerx's (obese, diabetic) mice bearing the NNT mutation.(4)
The mouse "RDA" for B3 is 15 mg/kg chow, and the Dietary Reference Intake RDA for B3 in humans is 16 mg/day, so this dose-response study(3) would suggest that optimal NR intake for humans is a mere 32 mg daily, and brings into further question whether there is any real advantage for NR over other forms of the vitamin.
*The initial in vitro muscle stem cell study in the Zhang et al Science report(5) used cells from the C57BL/10SnJ substrain, which does not appear to carry the mutation, but they used the Nnt-mutant C57BL/6JRj substrain both for the in vivo study on mitochondrial function and stem cell aging, and also for the lifespan study, and possibly for other parts that are not explicitly spelled out.
Reference
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