STM Article Repository

The decreased pools of nicotinamide adenine dinucleotide (NAD+) and subsequent decline in mitochondrial functions pave the way to many ageing-related disorders. Simultaneous restoration of cellular NAD+ and mitochondrial performance may be a powerful therapeutic approach in curing aged individuals. However, studies reporting synchronized increases in the levels of NAD+ and mitochondrial activity are yet to be made. Here, we report a systematic review of the available literature to determine whether integrating Chinese concepts in designing a Western-style medicine is an excellent strategy to promote the beneficial effects of NAD+ supplements in treating age-related phenotypes. We sought the potential benefits of some specific molecules (NAD+, nicotinic acid, urolithin A, pyrroloquinoline quinone) in enhancing NAD+ anabolism and mitochondrial efficiency. Synergistic and antagonistic effects of these molecules to treat ageing-related disorders were considered. Finally, a Western-style NAD+-boosting supplement formula based on the “monarch, minister, assistant, and envoy” philosophy of traditional Chinese medicine is proposed. The study's findings signified the role of NAD+, nicotinic acid, urolithin A, and pyrroloquinoline quinone as monarch, minister, assistant, and envoy, respectively. Accordingly, a proper formula is proposed to simultaneously enhance NAD+ anabolism and mitochondrial performance. The role of the proposed formula at multiple levels of organization, i.e., organelle, cell, organ, and body, is also highlighted to demonstrate the relevant beneficial effects. We conclude that the suggested NAD+ supplement exerts double-fold effects in improving cellular energy status because of its simultaneous action on NAD+ metabolism and mitochondrial performance. However, future studies, including pre-clinical/clinical trials and bioinformatics analyses, are crucial to approve the proposed action of the supplement formula in achieving long-term health benefits.