全球NMN和NAD+补充剂临床试验最全汇总

编者按

作为人体最重要的辅酶，NAD+的抗衰老作用被越来越多的研究发现，临床试验无疑是对其安全性和有效性最有力证明，本文将全球可以检索到的NAD+补充剂临床汇总起来供大家查阅。为加深理解，将先重点介绍几点，然后将相关临床罗列于后。

NAD+用药指南

相比于NAD+补充剂，直接补充NAD+更为直接（注射形式）。NAD+早已作临床药用，国内主要有注射用辅酶I和复合辅酶（辅酶A+辅酶I）,有意思是，复合辅酶的用法中有一条是“肿瘤病人要酌情加量”，这直接反驳了孤立地研究NAD+促癌的言论。

数据来源：CFDA网站

NAD+补充剂重要临床

任何临床都需要有相应的适应症，目前世界上没有一国家的药品监管部门承认衰老是一种疾病，因此不会有关于NAD+治疗衰老的临床。最大的进步是2018年世界卫生组织在《国际疾病法典》中宣布，衰老是一种可以治疗的疾病。所幸的是我们可以从其他相关研究中窥伺一二，1965年~1985年美国进行了一项名为“Coronary Drug Project”长达20年的临床试验，本来这个实验是为了分析心肌梗死患者服用降脂药是否会降低5年内死亡率，但采用了烟酸这种NAD+补充剂的双盲试验，可谓搂草打兔子。

在15年的临床试验中，1119人服用烟酸，2789人服用安慰剂，最后统计发现：实验组比安慰剂组的全因死亡率低11%，换个说法是烟酸延长了11%的寿命；更细的结果是：实验组比安慰剂组，心脏病和癌症的死亡率均降低，可以说是NAD+降低了癌症发生率。

数据来源：Fifteen Year Mortality in Coronary Drug Project Patients: Long-Term Benefit With Niacin

实验组和安慰剂组的全因死亡率

NMN临床

披露的NMN临床有4例，日本有3例NMN临床试验美国有1例。广岛大学最近公布长期口服的NMN中期临床试验：NMN提升了Sirtuin1水平，有助于辅助癌症治疗；庆应大学在结束了I期临床的基础上，于2017年开启了II期临床；美国华盛顿大学则于2017年开启了针对的是对糖代谢的I期临床。除了披露的临床试验据报道，Sinclair Metrobio study的NMN临床已经结束了一期，在进行二期临床。

数据来源：日本大学医院信息网UMIN-CTR Clinical Trial和美国ClinicalTrials.go

NMN是在近几年才广受关注，动物实验相对更多，将各个研究的动物实验罗列如下。

数据来源：各个研究文献，请查阅后文

NAD+补充剂临床

NAD+前体有长达60多年的安全用药史，有数十项临床到达III期、Ⅳ期，有的临床实验更是长达十几年，安全性无需顾虑。烟酰胺、烟酰胺核糖、烟酸、色氨酸是四类较差的NAD+补充剂，以下表格了检索了全球这四类NAD+补充剂的临床试验。其中烟酰胺和烟酰胺核糖有52项临床（考虑到语言问题，可能有遗漏；考虑到关键词，可能有重复），烟酸有52项临床（考虑到语言问题，可能有遗漏），色氨酸有20项临床（考虑到语言问题，可能有遗漏）。

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