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Selforganizology, 2027, 14(3-4): 25-33
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Article

Nicotinamide Adenine Dinucleotide (NAD+): Molecular mechanisms, clinical translation, and industrial application

WenJun Zhang
School of Life Sciences, Sun Yat-sen University, Guangzhou, China

Received 28 January 2026;Accepted 25 March 2026;Published online 31 March 2026;Published 1 December 2027
IAEES

Abstract
Nicotinamide adenine dinucleotide (NAD+) is one of the most functionally core small molecules in all living organisms. Early studies have confirmed that it acts as an electron carrier in redox reactions, and participates in core energy metabolism processes including glycolysis, tricarboxylic acid cycle, and fatty acid oxidation, thus serving as a key molecule for maintaining cellular energy homeostasis. In recent years, in-depth studies have further revealed that NAD+ is also widely involved in multiple critical biological processes such as DNA damage repair, protein translational modification, cellular stress response, and aging signaling pathway regulation, acting as a core regulatory node that connects cellular metabolism, organismal aging and disease pathogenesis. A large number of epidemiological and basic studies have confirmed that NAD+ levels in various mammalian tissues decrease progressively with age, and this reduction has a clear causal association with the occurrence and development of a variety of aging-related diseases, including metabolic diseases, neurodegenerative diseases, cardiovascular dysfunction, and tumors. Boosting cellular NAD+ levels via supplementation with NAD+ and its precursors has become a research hotspot in gerontology and translational medicine. This review systematically summarizes the research progress and current status of the NAD+ field from three dimensions: molecular mechanisms, clinical translation and industrial applications, and sorts out the existing controversies and unresolved problems in current research, aiming to provide a comprehensive reference framework for basic research, clinical drug development and health industry application related to NAD+.

Keywords Nicotinamide Adenine Dinucleotide (NAD+);NAD+ precursors;aging-related diseases;clinical translation;industrial application.


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