Q&A: Lung inflammation decreases with form of vitamin B3 in COPD

Key takeaways:

• Potential benefits of nicotinamide riboside in COPD include lower lung inflammation and elevated nicotinamide adenine dinucleotide levels.
• Future studies on this topic should include more patients and be longer.

Among patients with COPD, those receiving 6-week nicotinamide riboside, “a B3-like vitamin,” had significantly decreased lung inflammation, according to results published in Nature Aging.

In a double-blind, randomized, placebo-controlled trial, Morten Scheibye-Knudsen, MD, PhD, associate professor at the Center for Healthy Aging in the department of cellular and molecular medicine at the University of Copenhagen, and colleagues assessed 40 patients (mean age, 71.9 years) with COPD to uncover the impact of 6-week nicotinamide riboside vs. placebo on the lung inflammation marker, IL-8.

In contrast to patients receiving placebo, patients receiving nicotinamide riboside had a significant reduction in sputum IL-8 following the 6-week mark (least-squares mean change from baseline, –46.2%; 95% CI, –69.5% to –5.2% vs. 13.4%; 95% CI, –25.9% to 73.6%).

Notably, since the study was small and the CIs reported are sizable, researchers said to interpret them with caution.

Healio spoke with Scheibye-Knudsen to learn more about the study, nicotinamide riboside and what is needed in future research.

Healio: What was behind the decision to investigate nicotinamide riboside in patients with COPD?

Scheibye-Knudsen: COPD is associated with smoking, which induces DNA damage. DNA damage can lead to loss of nicotinamide adenine dinucleotide (NAD) and increased inflammation. Previous work has shown that nicotinamide riboside may reduce inflammation and increase NAD levels. We therefore thought nicotinamide riboside could be a potential new intervention for COPD.

Healio: How does the dose of nicotinamide riboside used in this study (twice daily 1 g) compare with available over-the-counter supplements?

Scheibye-Knudsen: Most clinical studies use 1 g to 3 g of nicotinamide riboside, which is a B3-like vitamin. B3 vitamin ingestion at that dose will typically lead to considerable side effects and is definitely not recommended. There is work from Yi and colleagues suggesting that it may be possible to get a similar effect from 600 mg of nicotinamide riboside.

Healio: Why did you choose to assess lung inflammation as an endpoint?

Scheibye-Knudsen: Lung inflammation is thought to be part of the pathogenesis of COPD, and IL-8 is one of the inflammatory cytokines that may contribute to reduced lung function over time. Inflammation has also previously been shown to be affected by treatment with nicotinamide riboside.

Healio: You also examined how nicotinamide riboside impacts NAD levels in blood. Why is the finding of elevated NAD levels in patients who received nicotinamide riboside relevant moving forward?

Scheibye-Knudsen: Nicotinamide riboside can be used by the cells in our body to make NAD. When you eat nicotinamide riboside, you increase NAD levels. We discovered that NAD levels are lower in COPD patients. I believe we are the first to show this.

Healio: Healio previously reported on a study that found that respiratory-specific quality of life and exacerbation odds in former smokers with COPD may improve with elevated omega-3 levels . Why should clinicians think about diet/supplements when treating an individual with COPD?

Scheibye-Knudsen: Supplements are typically associated with minimal risk for side effects. There is no curative treatment of COPD, and anything that can reduce the decline in lung function could therefore be a good treatment option; however, this needs to be explored further.

Healio: What should future studies on this topic look into/assess when furthering this research?

Scheibye-Knudsen: Our study was a relatively small study, and larger studies with longer treatment durations need to be conducted to confirm our results. Larger studies should investigate lung function in addition to inflammation.

For more information:

Morten Scheibye-Knudsen, MD, PhD, can be reached at mscheibye@sund.ku.dk.

References:

• New study shows promising results for COPD treatment. https://news.ku.dk/all_news/2024/11/new-study-shows-promising-results-for-copd-treatment/. Published Nov. 19, 2024. Accessed Nov. 20, 2024.
• Yi L, et al. Geroscience. 2022;doi:10.1007/s11357-022-00705-1.