Hotchkiss Brain Institute, 3330 Hospital Drive NW, Calgary, AB, Canada.
Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
Neurotherapeutics. 2023 Jul;20(4):1037-1054. doi: 10.1007/s13311-023-01376-2. Epub 2023 Apr 21.
Niacin (vitamin B3) is an essential nutrient that treats pellagra, and prior to the advent of statins, niacin was commonly used to counter dyslipidemia. Recent evidence has posited niacin as a promising therapeutic for several neurological disorders. In this review, we discuss the biochemistry of niacin, including its homeostatic roles in NAD supplementation and metabolism. Niacin also has roles outside of metabolism, largely through engaging hydroxycarboxylic acid receptor 2 (Hcar2). These receptor-mediated activities of niacin include regulation of immune responses, phagocytosis of myelin debris after demyelination or of amyloid beta in models of Alzheimer's disease, and cholesterol efflux from cells. We describe the neurological disorders in which niacin has been investigated or has been proposed as a candidate medication. These are multiple sclerosis, Alzheimer's disease, Parkinson's disease, glioblastoma and amyotrophic lateral sclerosis. Finally, we explore the proposed mechanisms through which niacin may ameliorate neuropathology. While several questions remain, the prospect of niacin as a therapeutic to alleviate neurological impairment is promising.
烟酸（维生素 B3）是一种必需的营养物质，可治疗糙皮病，在他汀类药物问世之前，烟酸常用于治疗血脂异常。最近的证据表明，烟酸是几种神经疾病有前途的治疗药物。在这篇综述中，我们讨论了烟酸的生物化学，包括其在 NAD 补充和代谢中的稳态作用。烟酸在代谢之外也有作用，主要是通过结合羟基羧酸受体 2（Hcar2）。这些受体介导的烟酸活性包括调节免疫反应、脱髓鞘后髓鞘碎片的吞噬作用或阿尔茨海默病模型中的淀粉样β，以及细胞内胆固醇的流出。我们描述了烟酸已被研究或被提议作为候选药物的神经疾病。这些疾病包括多发性硬化症、阿尔茨海默病、帕金森病、胶质母细胞瘤和肌萎缩侧索硬化症。最后，我们探讨了烟酸可能改善神经病理学的拟议机制。虽然仍有一些问题悬而未决，但烟酸作为一种治疗方法来减轻神经损伤的前景是有希望的。
