Department of Ophthalmology, University of Campinas, São Paulo, Brazil.
Eur J Ophthalmol. 2023 Sep;33(5):1801-1815. doi: 10.1177/11206721231161101. Epub 2023 Mar 14.
Glaucoma is an optic neuropathy characterized by death of retinal ganglion cells (RGCs), which leads to progressive visual field loss and may result in blindness. Currently, the only available treatment to avoid or delay progression in glaucoma patients is to decrease intraocular pressure (IOP). However, despite adequate IOP control, approximately 25% of the patients continue to progress. To delay or prevent optic nerve damage in glaucoma, two forms of vitamin B3, nicotinamide (NAM) and nicotinamide riboside (NR) are emerging as viable adjuvant therapies. These compounds are nicotinamide adenine dinucleotide (NAD) precursors. NAD is essential for proper cell functioning and is involved in several metabolic activities, including protection against reactive oxygen species, contribution to the performance of various enzymes, and maintenance of mitochondrial function. Due to its beneficial effects and to the evidence of the reduction of NAD bioavailability with aging, researchers are seeking ways to replenish the cellular NAD pool, by administrating its precursors (NAM and NR), believing that it will reduce the RGC vulnerability to external stressors, such as increased IOP. This article attempts to analyze the current knowledge regarding the use of NAM and NR for the prevention and/or treatment of glaucoma.
青光眼是一种视神经病变，其特征是视网膜神经节细胞（RGCs）死亡，导致进行性视野丧失，并可能导致失明。目前，避免或延缓青光眼患者病情进展的唯一可用治疗方法是降低眼内压（IOP）。然而，尽管眼压得到了适当的控制，大约 25%的患者仍会继续进展。为了延缓或预防青光眼视神经损伤，两种形式的维生素 B3，烟酰胺（NAM）和烟酰胺核苷（NR）作为可行的辅助治疗方法正在出现。这些化合物是烟酰胺腺嘌呤二核苷酸（NAD）的前体。NAD 对细胞正常功能至关重要，参与多种代谢活动，包括抵抗活性氧、促进各种酶的活性以及维持线粒体功能。由于其有益的作用以及随着年龄的增长 NAD 生物利用度降低的证据，研究人员正在寻求通过给予其前体（NAM 和 NR）来补充细胞 NAD 池的方法，认为这将降低 RGC 对外部应激源（如升高的 IOP）的脆弱性。本文试图分析目前关于使用 NAM 和 NR 预防和/或治疗青光眼的知识。
