Zhou Fang-Qiang
Fresenius Medical Care, Dialysis Centers, Chicago, IL, USA.
Nutr Metab Insights. 2021 Oct 26;14:11786388211053407. doi: 10.1177/11786388211053407. eCollection 2021.
In last decades, healthy aging has become one of research hotspots in life science. It is well known that the nicotinamide adenine dinucleotide oxidized form (NAD) level in cells decreases with aging and aging-related diseases. Several years ago, one of NAD precursors was first demonstrated with its new role in DNA damage repairing in mice, restoring old mice to their physical state at young ones. The finding encourages extensive studies in animal models and patients. NAD and its precursors have been popular products in nutrition markets. Alternatively, it was also evidenced that clearance of cellular senescence by senolytics preserved multiorgan (kidney and heart) function and extended healthy lifespan in mice. Subsequent studies confirmed findings in elderly patients subjected with idiopathic pulmonary fibrosis. The senolytic therapy is now focused on various diseases in animal and clinical studies. However, pyruvate, as both a NAD substitute and a new senolytic, may be advantageous, on the equimolar basis, over current products above in preventing and treating diseases and aging. Pyruvate-enriched fluids, particularly pyruvate oral rehydration salt, may be a novel intervention for diseases and aging besides critical care. Albeit the direct evidence that benefits healthy aging is still limited to date, pyruvate, as both NAD provider and senolytic agent, warrants intensive research to compare NAD or senolytics for healthy aging, specifically on the equimolar basis, in effective blood levels. This review briefly discussed the recognition of healthy aging by comparing NAD and Senolytics with sodium pyruvate from the clinical point of view.
在过去几十年中，健康老龄化已成为生命科学的研究热点之一。众所周知，细胞中烟酰胺腺嘌呤二核苷酸氧化形式（NAD）的水平会随着衰老及与衰老相关的疾病而降低。几年前，NAD的一种前体首次在小鼠的DNA损伤修复中展现出新作用，能使老年小鼠恢复到年轻小鼠的身体状态。这一发现促使在动物模型和患者中展开广泛研究。NAD及其前体已成为营养市场上的热门产品。另外，也有证据表明，使用衰老细胞溶解剂清除细胞衰老可维持多器官（肾脏和心脏）功能，并延长小鼠的健康寿命。后续研究在患有特发性肺纤维化的老年患者中证实了这一发现。目前，衰老细胞溶解疗法在动物和临床研究中聚焦于各种疾病。然而，丙酮酸作为NAD替代品和新型衰老细胞溶解剂，在等摩尔基础上，可能比上述现有产品在预防和治疗疾病及衰老方面更具优势。富含丙酮酸的液体，特别是丙酮酸口服补液盐，可能是除重症监护之外针对疾病和衰老的一种新型干预措施。尽管目前有利于健康老龄化的直接证据仍然有限，但丙酮酸作为NAD供应者和衰老细胞溶解剂，值得深入研究，以便在有效血药浓度下，特别是在等摩尔基础上，比较其与NAD或衰老细胞溶解剂对健康老龄化的作用。本综述从临床角度通过比较NAD、衰老细胞溶解剂和丙酮酸钠简要讨论了对健康老龄化的认识。
