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烟酰胺腺嘌呤二核苷酸在心血管疾病中的研究进展

文赵之¹, 杨怿航¹, 刘东^1,2, 施冲旭^1,*

¹南通大学生命科学学院，南通市发育与疾病重点实验室，南通 226000；²神经再生协同创新中心，南通大学江苏省神经再生重点实验室，南通 226000

摘要

心血管疾病(cardiovascular disease, CVD)是造成全球性死亡率升高的主要原因。烟酰胺腺嘌呤二核苷酸(nicotinamideadenine dinucleotide, NAD+)是一种多功能的辅酶，参与多种生物学过程，如细胞能量代谢、细胞信号传导、DNA修复和蛋白质修饰等。许多研究表明，NAD+水平随着年龄、肥胖和高血压等CVD的风险因素而降低。此外，提高机体NAD+水平还可以减轻慢性炎症反应、重新激活自噬和线粒体的生物功能。在患有血管疾病的人类中，提高NAD+水平还能增强细胞的抗氧化和代谢能力。动物模型研究发现，NAD+水平的提高还能降低血压、增加寿命、预防代谢相关疾病。最近有研究揭示，通过基因手段、药物或日常饮食提升NAD+水平，能有效改善动物和人类心血管健康的病理生理状况。在本综述中，我们首先详细阐述了NAD+在维持血管健康方面的作用，然后总结了其与血管功能和疾病相关的最新研究进展，包括高血压、动脉粥样硬化和冠状动脉疾病等。此外，本综述还评估了各种NAD+前体在提升NAD+水平方面的效率，以及这些NAD+前体对预防或治疗CVD的临床效果，旨在为新的治疗策略提供潜在参考。

关键词： 烟酰胺腺嘌呤二核苷酸; 心血管疾病; 炎症; 血管健康

NAD⁺metabolism in cardiovascular diseases

WEN Zhao-Zhi¹, YANG Yi-Hang¹, LIU Dong^1,2, SHI Chong-Xu^1,*

¹Nantong Laboratory of Development and Diseases, School of Life Science, Nantong University, Nantong 226000, Chi；²Co-Innovation Center of Neuroregeneration, Key Laboratory of Neuroregeneration of Jiangsu and Ministry of Education, Nantong University, Nantong 226000, China

Abstract

Cardiovascular diseases (CVDs) are the leading cause of death worldwide. Nicotinamide adenine dinucleotide (NAD+) is acentral and pleiotropic metabolite involved in multiple cellular energy metabolism, such as cell signaling, DNA repair, protein modifications,and so on. Evidence suggests that NAD+ levels decline with age, obesity, and hypertension, which are all significant CVDrisk factors. In addition, the therapeutic elevation of NAD+ levels reduces chronic low-grade inflammation, reactivates autophagy andmitochondrial biogenesis, and enhances antioxidation and metabolism in vascular cells of humans with vascular disorders. In preclinicalanimal models, NAD+ boosting also extends the health span, prevents metabolic syndrome, and decreases blood pressure. Moreover,NAD+ storage by genetic, pharmacological, or natural dietary NAD+-increasing strategies has recently been shown to be effectivein improving the pathophysiology of cardiac and vascular health in different animal models and humans. Here, we discuss NAD+-related mechanisms pivotal for vascular health and summarize recent research on NAD+ and its association with vascular health anddisease, including hypertension, atherosclerosis, and coronary artery disease. This review also assesses various NAD+ precursors fortheir clinical efficacy and the efficiency of NAD+ elevation in the prevention or treatment of major CVDs, potentially guiding newtherapeutic strategies.

Key words: nicotinamide adenine dinucleotide; cardiovascular diseases; inflammation; vascular healt

收稿日期：　　录用日期：

通讯作者：施冲旭　　E-mail:

DOI: 10.13294/j.aps.2025.0034

引用本文：

文赵之, 杨怿航, 刘东, 施冲旭. 烟酰胺腺嘌呤二核苷酸在心血管疾病中的研究进展[J]. 生理学报 2025; 77 (2): 345-360.

WEN Zhao-Zhi, YANG Yi-Hang, LIU Dong, SHI Chong-Xu. NAD⁺metabolism in cardiovascular diseases. Acta Physiol Sin 2025; 77 (2): 345-360 (in Chinese with English abstract).