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NAD+ precursors prolong survival and improve cardiac phenotypes in a mouse model of Friedreich’s Ataxia
Caroline E. Perry, … , David R. Lynch, Joseph A. Baur
Caroline E. Perry, … , David R. Lynch, Joseph A. Baur
Published August 22, 2024
Citation Information: JCI Insight. 2024;9(16):e177152. https://doi.org/10.1172/jci.insight.177152.
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Research Article Cardiology Metabolism

NAD+ precursors prolong survival and improve cardiac phenotypes in a mouse model of Friedreich’s Ataxia

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Abstract

Friedreich’s ataxia (FRDA) is a progressive disorder caused by insufficient expression of frataxin, which plays a critical role in assembly of iron-sulfur centers in mitochondria. Individuals are cognitively normal but display a loss of motor coordination and cardiac abnormalities. Many ultimately develop heart failure. Administration of nicotinamide adenine dinucleotide–positive (NAD+) precursors has shown promise in human mitochondrial myopathy and rodent models of heart failure, including mice lacking frataxin in cardiomyocytes. We studied mice with systemic knockdown of frataxin (shFxn), which display motor deficits and early mortality with cardiac hypertrophy. Hearts in these mice do not “fail” per se but become hyperdynamic with small chamber sizes. Data from an ongoing natural history study indicate that hyperdynamic hearts are observed in young individuals with FRDA, suggesting that the mouse model could reflect early pathology. Administering nicotinamide mononucleotide or riboside to shFxn mice increases survival, modestly improves cardiac hypertrophy, and limits increases in ejection fraction. Mechanistically, most of the transcriptional and metabolic changes induced by frataxin knockdown are insensitive to NAD+ precursor administration, but glutathione levels are increased, suggesting improved antioxidant capacity. Overall, our findings indicate that NAD+ precursors are modestly cardioprotective in this model of FRDA and warrant further investigation.

Authors

Caroline E. Perry, Sarah M. Halawani, Sarmistha Mukherjee, Lucie V. Ngaba, Melissa Lieu, Won Dong Lee, James G. Davis, Gabriel K. Adzika, Alyssa N. Bebenek, Daniel D. Bazianos, Beishan Chen, Elizabeth Mercado-Ayon, Liam P. Flatley, Arjun P. Suryawanshi, Isabelle Ho, Joshua D. Rabinowitz, Suraj D. Serai, David M. Biko, Jaclyn Tamaroff, Anna DeDio, Kristin Wade, Kimberly Y. Lin, David J. Livingston, Shana E. McCormack, David R. Lynch, Joseph A. Baur

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Figure 6

NAD+ precursor treatment amplifies glutathione synthesis in shFxn hearts.

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NAD+ precursor treatment amplifies glutathione synthesis in shFxn hearts...
(A) Plasma nicotinamide and 2-PY levels are increased in treated mice. (B) NAD+ and NADP+ are significantly depleted in shFxn hearts, with recovery of NADP with NMN treatment. NADH and NADPH levels are unchanged with loss of frataxin and with precursor treatment. (C) Heatmap of metabolites significantly changed with NR and NMN treatment (pooled analysis). Bolded metabolites were significantly modified by depletion of frataxin. (D) Using list in C, Metaboanalyst identified glutathione metabolism as significantly changed by treatment in shFxn hearts. (E) Glutathione related metabolites are altered in shFxn mice and treated mice. [Box Plots: Metabolite-[group:mean, lower, upper]] [Glutathione-[WT:1, 0.46, 1.97; shFxn:1.57, 1.33, 1.71; NR:2.189, 2.04, 2.39; NMN:2.40, 1.24, 2.97] Glutathione Disulfide-[WT:1, 0.68, 1.16; shFxn:1.02, 0.95, 1.11; NR:1.35, 1.23, 1.43; NMN:1.49, 1.25, 2.00] γ-glutamylcysteine-[WT:1, 0.71, 1.52; shFxn:0.39, 0.22, 0.53; NR:0.72, 0.54, 0.83; NMN:0.72, 0.39, 1.00] γ-glutamyltaurine-[WT:1, 0.17, 2.97; shFxn:3.27, 2.70, 3.87; NR:2.05, 0.84, 2.81; NMN:1.95, 1.32, 2.77] Glycine-[WT:1, 0.86, 1.14; shFxn:1.21, 1.09, 1.35; NR:1.34, 1.02, 1.55; NMN:1.54, 1.185, 1.94]. Brackets indicate pairwise comparisons with P values indicated for several that did not reach significance. (F) Model representing metabolite changes in glutathione synthesis pathways. Left arrow is direction in shFxn vs. WT mice, right arrow with glow is direction in shFxn vs. treated mice, red symbols are upregulated in shFxn mice, blue symbols are downregulated, and green are unchanged. A, B, and E, n = 6–17, 1-way ANOVA, Fisher’s LSD test); C, n = 6–17, normalized ion value, 2-tailed t test (*P ≤ 0.05, **P ≤ 0.01, ***P ≤ 0.001, ****P ≤ 0.0001).

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