Quantitation of NAD+: Why do we need to measure it?

BACKGROUND: Nicotinamide adenine dinucleotide (NAD⁺) is an essential pyridine nucleotide that is currently investigated as an important target to extend lifespan and health span. Age-related NAD+ depletion due to the accumulation of oxidative stress is associated with reduced energy production, impaired DNA repair and genomic instability. SCOPE OF REVIEW: NAD+ levels can be elevated therapeutically using NAD+ precursors or through lifestyle modifications including exercise and caloric restriction. However, high amounts of NAD+ may be detrimental in cancer progression and may have deleterious immunogenic roles. MAJOR CONCLUSIONS: Standardized quantitation of NAD+ and related metabolites may therefore represent an important component of NAD+ therapy. GENERAL SIGNIFICANCE: Quantitation of NAD+ may serve dual roles not only as an ageing biomarker, but also as a diagnostic tool for the prevention of malignant disorders.