NAD+ metabolism drives astrocyte proinflammatory reprogramming in central nervous system autoimmunity, 2022, Tom Meyer et al

Mij

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Significance

NAD+ has emerged as an important cofactor that can rewire metabolism and link energy status with cellular immune response reprogramming, raising the possibility that an improved understanding of NAD+ immunometabolic function in neuroinflammation could be exploited therapeutically.

We have now identified the enzymes NAMPT, CD38, and the transcription factor NFATC3 as critical nodes in regulating astrocyte pathogenicity and controlling experimental neuroinflammation. Importantly, we have corroborated these murine findings in human astrocytes and analysis of MS brain samples. Overall, our results describe the role of NAD+ metabolism in the local immune response in the CNS and reveal targetable mechanistic insights into how NAD+ immunometabolic signaling controls astrocyte activation and promotes CNS autoimmunity.

Abstract

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS). Astrocytes are the most abundant glial cells in the CNS, and their dysfunction contributes to the pathogenesis of MS and its animal model, experimental autoimmune encephalomyelitis (EAE).

Recent advances highlight the pivotal role of cellular metabolism in programming immune responses. However, the underlying immunometabolic mechanisms that drive astrocyte pathogenicity remain elusive.

Nicotinamide adenine dinucleotide (NAD+) is a vital coenzyme involved in cellular redox reactions and a substrate for NAD+-dependent enzymes. Cellular NAD+ levels are dynamically controlled by synthesis and degradation, and dysregulation of this balance has been associated with inflammation and disease. Here, we demonstrate that cell-autonomous generation of NAD+ via the salvage pathway regulates astrocyte immune function. Inhibition of nicotinamide phosphoribosyltransferase (NAMPT), a key enzyme in the salvage pathway, results in depletion of NAD+, inhibits oxidative phosphorylation, and limits astrocyte inflammatory potential. We identified CD38 as the main NADase up-regulated in reactive mouse and human astrocytes in models of neuroinflammation and MS. Genetic or pharmacological blockade of astrocyte CD38 activity augmented NAD+ levels, suppressed proinflammatory transcriptional reprogramming, impaired chemotactic potential to inflammatory monocytes, and ameliorated EAE.

We found that CD38 activity is mediated via calcineurin/NFAT signaling in mouse and human reactive astrocytes. Thus, NAMPT–NAD+–CD38 circuitry in astrocytes controls their ability to meet their energy demands and drives the expression of proinflammatory transcriptional modules, contributing to CNS pathology in EAE and, potentially, MS. Our results identify candidate therapeutic targets in MS.

https://www.pnas.org/doi/10.1073/pnas.2211310119
 
I have been pondering astrocytes and CD38 and apparently daratumumab (edit: may be able to) cross the blood brain barrier

The Daratumumab Crosses the Blood Brain Barrier, 2018, Vercruyssen et al

Vercruyssen, Marie; El Hachem, Georges; Maerevoet, Marie

Abstract
NK/T cell lymphoma is a rare disease in our Western countries counting for less than 1% of all non-Hodgkin lymphomas but is more and more observed due to globalization. The central nervous system (CNS) could be involved in more than 5% of the cases at relapse with a catastrophic median overall survival after diagnosis of 2.53 months. It is an unmet medical need with new therapeutic options needed.

Daratumumab is a monoclonal antibody directed against CD38 which the NK cells harbour. Some data suggest an efficacy against of that drug against NK/T cell lymphoma. In order to consider the Daratumumab as a potential therapeutic option in the NK/T cell with CNS involvement, we wanted to assess whether this antibody crosses the blood brain barrier.

We assess the presence of the Daratumumab in the cerebrospinal fluid (CSF) at different steps of a patient with CNS involvement of a NK/T cell lymphoma while he was treated with Daratumumab alone. With this goal, we realized a qualitative isoectrofocusing in the blood and the CSF baseline and after every Daratumumab administration. With this method, we couldn't observe any focusing in the blood before the first Daratumumab administration. In the CSF, we could just observe a profile compatible with the neoplastic infiltration.

After the first injection of the Daratumumab, which is a monoclonal antibody, we could observe the appearance of a monoclonal band in the blood, becoming more and more obvious as long as the patient received the drug week after week. In the CSF, we could observe more discreetly but obviously the same phenomenon in parallel, witnessing the crossing of the Daratumumab through the intact blood brain barrier.

From that observation, we can attest that the Daratumumab is able to cross the blood brain barrier making this drug a very interesting one in the field of the CNS involvement of some malignancies harbouring the CD38 on their surface as the plasma cell leukemia, the multiple myeloma and the NK/T cell lymphoma. Some quantitative data and further evaluations must be done in order to assess the efficacy of the Daratumumab in these indications.

Web | DOI | Clinical Lymphoma Myeloma and Leukemia
 
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And this paper talks about effects of inhibiting CD38, which I think an anti-cd38 mab would do in some circumstances? May tie in to the NAD+ stuff above?

Inhibition of CD38 and supplementation of nicotinamide riboside ameliorate lipopolysaccharide‐induced microglial and astrocytic neuroinflammation by increasing NAD+, 2021, Roboon et al

Roboon, Jureepon; Hattori, Tsuyoshi; Ishii, Hiroshi; Takarada‐Iemata, Mika; Nguyen, Dinh Thi; Heer, Collin D.; O'Meally, Denis; Brenner, Charles; Yamamoto, Yasuhiko; Okamoto, Hiroshi; Higashida, Haruhiro; Hori, Osamu

Abstract
Neuroinflammation is initiated by activation of the brain's innate immune system in response to an inflammatory challenge. Insufficient control of neuroinflammation leads to enhanced or prolonged pathology in various neurological conditions including multiple sclerosis and Alzheimer's disease.

Nicotinamide adenine dinucleotide (NAD+) plays critical roles in cellular energy metabolism and calcium homeostasis. Our previous study demonstrated that deletion of CD38, which consumes NAD+, suppressed cuprizone‐induced demyelination, neuroinflammation, and glial activation. However, it is still unknown whether CD38 directly affects neuroinflammation through regulating brain NAD+ level.

In this study, we investigated the effect of CD38 deletion and inhibition and supplementation of NAD+ on lipopolysaccharide (LPS)‐induced neuroinflammation in mice. Intracerebroventricular injection of LPS significantly increased CD38 expression especially in the hippocampus. Deletion of CD38 decreased LPS‐induced inflammatory responses and glial activation. Pre‐administration of apigenin, a flavonoid with CD38 inhibitory activity, or nicotinamide riboside (NR), an NAD+ precursor, increased NAD+ level, and significantly suppressed induction of cytokines and chemokines, glial activation and subsequent neurodegeneration after LPS administration. In cell culture, LPS‐induced inflammatory responses were suppressed by treatment of primary astrocytes or microglia with apigenin, NAD+, NR or 78c, the latter a specific CD38 inhibitor.

Finally, all these compounds suppressed NF‐κB signaling pathway in microglia. These results suggest that CD38‐mediated neuroinflammation is linked to NAD+ consumption and that boosting NAD+ by CD38 inhibition and NR supplementation directly suppress neuroinflammation in the brain. image

Web | DOI | PMC | PDF | Journal of Neurochemistry
 

NAD improves cognitive function and reduces neuroinflammation by ameliorating mitochondrial damage and decreasing ROS production in chronic cerebral hypoperfusion models through Sirt1/PGC-1α pathway​



NAD+ administration rescued cognitive deficits and inhibited neuroinflammation by protecting mitochondria and decreasing ROS production in CCH rats. Results of mechanistic pathway analysis indicated that the detrimental effects of CCH might be associated with decreased gene expression of PPAR-γ co-activator1α (PGC-1α) and its upstream transcription factor Sirt1, while NAD+ treatment markedly reversed their decrease. In vitro study confirmed that NAD+ administration had protective effects on hypoxia-induced neuroinflammation and mitochondrial damage, as well as ROS production in BV2 microglia via Sirt1/PGC-1α pathway. Sirt1 overexpression mimicked the protective effects of NAD+ treatment in BV2 microglia.


I didn't know how important NAD is. I better start taking it, along with Sirt1 agonists.
I see that CoQ10 enhances PGC-1a, and I am wondering if that is why geranylgeraniol is helping me so much.

Now I am seeing so many studies in the similar threads category.
 
I didn't know how important NAD is.

I think we all grew up learning how central NAD is to everything. But if there is no neuroinflammation in ME/CFS taking more does not seem warranted. It may have significant toxic effects.

The animal model used in the cited paper is pretty gross. It is hardly surprising that NAD altered the situation in a grossly ischaemic brain.
 
"Yet, CD38 expression increases as a consequence of aging which is otherwise the primary risk associated with neurodegenerative diseases, and several experimental data demonstrated that CD38 knockout mice are protected from neurodegenerative and neuroinflammatory insults."

What is it about aging, (and ME/CFS) that increases CD38 expression?
 
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