Nicotinamide riboside (NR), a type of vitamin B3, may prevent chemotherapy-induced peripheral neuropathy (CIPN), a recent study in animals has shown. Although chemotherapy increases survival rates, it can have serious side effects, including peripheral neuropathy, that affect quality of life.1
“Our findings support the idea that NR could potentially be used to prevent or mitigate CIPN in cancer patients, resulting in a meaningful improvement in their quality of life and the ability to sustain better and longer treatment,” said Marta Hamity, PhD, assistant research scientist at University of Iowa, Iowa City.
For this study, the researchers examined the effects of nicotinamide riboside on female rats treated with paclitaxel. Paclitaxel is a chemotherapy frequently used to treat breast cancer and ovarian cancer.
Administration of paclitaxel at clinically relevant doses caused peripheral neuropathy that persisted 5 weeks past the termination of chemotherapy.
Assessment of peripheral neuropathy is achieved in rats via a light foot poke (ie, rats withdraw their feet on application of light pressure). Treatment with paclitaxel made the rats hypersensitive to light touch.
Rats given prophylactic daily doses of nicotinamide riboside at 200 mg/kg 7 days prior to chemotherapy and continuing for 24 days after the termination of chemotherapy did not experience peripheral nerve hypersensitivity. This protective effect persisted for 2 weeks after the cessation of nicotinamide riboside.
Nicotinamide riboside increases cellular levels of nicotinamide adenine dinucleotide (NAD+), a metabolite correlated with neuroprotection. Nicotinamide riboside supplementation increased serum NAD+ levels by approximately 50%.
Researchers additionally developed a new approach, an escape test, to measure how unpleasant light touch is to rats with peripheral neuropathy. In this new approach, rats could choose between a dark environment in which their feet were repeatedly poked and a light environment in which their feet were not poked. Rats naturally prefer dark environments.
Rats that had not undergone chemotherapy withstood many pokes before leaving the dark environment. Rats with peripheral neuropathy, however, quickly left the dark environment. Rats who received nicotinamide riboside behaved more similarly to untreated rats.
When administration of nicotinamide riboside began 14 days after chemotherapy, peripheral neuropathy resolved in some but not all rats. The escape behavior, however, was reduced in all rats.
1. Hamity MV, White SR, Walder RY, Schmidt MS, Brenner C, Hammond DL. Nicotinamide riboside, a form of vitamin B3 and NAD+ precursor, relieves the nociceptive and aversive dimensions of paclitaxel-induced peripheral neuropathy in female rats. PAIN. 2017 Jan 30. doi: 10.1097/j.pain.0000000000000862 [Epub ahead of print]