A Noninvasive Urine Metabolome Panel as Potential Biomarkers for Diagnosis of T Cell-Mediated Renal Transplant Rejection.

Acute T cell-mediated rejection (TCMR) is a major complication after renal transplantation. TCMR diagnosis is very challenging and currently depends on invasive renal biopsy and nonspecific markers such as serum creatinine. A noninvasive metabolomics panel could allow early diagnosis and improved accuracy and specificity. We report, in this study, on urine metabolome changes in renal transplant recipients diagnosed with TCMR, with a view to future metabolomics-based diagnostics in transplant medicine. We performed urine metabolomic analyses in three study groups: (1) 7 kidney transplant recipients with acute TCMR, (2) 15 kidney transplant recipients without rejection but with impaired kidney function, and (3) 6 kidney transplant recipients with stable renal function, using 1H-nuclear magnetic resonance. Multivariate modeling of metabolites suggested a diagnostic panel where the diagnostic accuracy of each metabolite was calculated by receiver operating characteristic curve analysis. The impaired metabolic pathways associated with TCMR were identified by pathway analysis. In all, a panel of nine differential metabolites encompassing nicotinamide adenine dinucleotide, 1-methylnicotinamide, cholesterol sulfate, gamma-aminobutyric acid (GABA), nicotinic acid, nicotinamide adenine dinucleotide phosphate, proline, spermidine, and alpha-hydroxyhippuric acid were identified as novel potential metabolite biomarkers of TCMR. Proline, spermidine, and GABA had the highest area under the curve (>0.7) and were overrepresented in the TCMR group. Nicotinate and nicotinamide metabolism was the most important pathway in TCMR. These findings call for clinical validation in larger study samples and suggest that urinary metabolomics warrants future consideration as a noninvasive research tool for TCMR diagnostic innovation.

Clinical Assessment of the NADome as Biomarkers for Healthy Aging.

Nicotinamide adenine dinucleotide (NAD+) and its related metabolites (NADome) are important endogenous analytes that are thought to play important roles in cellular metabolism, inflammation, oxidative stress, cancer, neurodegeneration, and aging in mammals. However, these analytes are unstable during the collection of biological fluids, which is a major limiting factor for their quantitation. Herein, we describe a highly robust and quantitative method using liquid chromatography coupled to tandem mass spectrometry to quantify the NADome in whole blood, plasma, mononuclear cells, platelets, cerebrospinal fluid (CSF), and urine. This methodology represents a "gold standard" of measure for understanding biological pathways and developing targeted pharmacological interventions to modulate NAD+ biosynthesis and NAD-dependent mediators in health and disease.

Safety and Metabolism of Long-term Administration of NIAGEN (Nicotinamide Riboside Chloride) in a Randomized, Double-Blind, Placebo-controlled Clinical Trial of Healthy Overweight Adults.

Nicotinamide riboside (NR) is a newly discovered nicotinamide adenine dinucleotide (NAD+) precursor vitamin. A crystal form of NR chloride termed NIAGEN is generally recognized as safe (GRAS) for use in foods and the subject of two New Dietary Ingredient Notifications for use in dietary supplements. To evaluate the kinetics and dose-dependency of NR oral availability and safety in overweight, but otherwise healthy men and women, an 8-week randomized, double-blind, placebo-controlled clinical trial was conducted. Consumption of 100, 300 and 1000 mg NR dose-dependently and significantly increased whole blood NAD+ (i.e., 22%, 51% and 142%) and other NAD+ metabolites within 2 weeks. The increases were maintained throughout the remainder of the study. There were no reports of flushing and no significant differences in adverse events between the NR and placebo-treated groups or between groups at different NR doses. NR also did not elevate low density lipoprotein cholesterol or dysregulate 1-carbon metabolism. Together these data support the development of a tolerable upper intake limit for NR based on human data.

A study for the detection of kidney cancer using fluorescence emission spectra and synchronous fluorescence excitation spectra of blood and urine.

In this study, we compared different types of biomolecular markers in kidney cancer patients and in normal healthy controls, using fluorescence emission spectra and synchronous fluorescence excitation spectra. We were able to provide an accurate classification of the spectral features of kidney cancer patients relative to that of normal controls, in terms of the concentration ratios of biomolecules (viz., tryptophan, NADH, FAD, basic porphyrin, and acidic porphyrin) based on the intensity of their spectral peaks. The specificity and sensitivity of the method were 90%. The rationale of our current approach is to evolve an innovative protocol for the spectral characterization of in vitro optical analyses suitable for both small clinics and hospitals.

Nicotinamide riboside is uniquely and orally bioavailable in mice and humans.

Nicotinamide riboside (NR) is in wide use as an NAD+ precursor vitamin. Here we determine the time and dose-dependent effects of NR on blood NAD+ metabolism in humans. We report that human blood NAD+ can rise as much as 2.7-fold with a single oral dose of NR in a pilot study of one individual, and that oral NR elevates mouse hepatic NAD+ with distinct and superior pharmacokinetics to those of nicotinic acid and nicotinamide. We further show that single doses of 100, 300 and 1,000 mg of NR produce dose-dependent increases in the blood NAD+ metabolome in the first clinical trial of NR pharmacokinetics in humans. We also report that nicotinic acid adenine dinucleotide (NAAD), which was not thought to be en route for the conversion of NR to NAD+, is formed from NR and discover that the rise in NAAD is a highly sensitive biomarker of effective NAD+ repletion.

ß-Nicotinamide Mononucleotide, an Anti-Aging Candidate Compound, Is Retained in the Body for Longer than Nicotinamide in Rats.

The turnover of the oxidized form of nicotinamide adenine dinucleotide (NAD+) has attracted interest in regard to longevity. Thus, compounds that can rapidly increase the cellular NAD+ concentration have been surveyed by many researchers. Of those, ß-nicotinamide mononucleotide (ß-NMN) has been focused on. Studies on the biosynthesis of NAD+ from ß-NMN have been reported at the cellular level, but not at the whole animal level. In the present study, we investigated whether ß-NMN is superior to nicotinamide (Nam) as a precursor of NAD+ in whole animal experiments. To this end we compared the NAD+ concentration in the blood and the urinary excretion amounts of NAD+ catabolites. Rats were intraperitoneally injected with ß-NMN or Nam. After the injection, blood samples and urine samples were collected at 3-h intervals. The concentration of blood total NAD (NAD11NADH) in each sample showed no significant differences between the two groups. The urinary excretion amounts of NAD+ catabolites in the urine samples collected at 3-6 h after the injection were lower in the ß-NMN group than in the Nam group. These results suggest that ß-NMN is retained in the body for longer than Nam.

Au nanoparticle/graphene nanocomposite as a platform for the sensitive detection of NADH in human urine.

Here we report on a facile, rapid, sensitive, selective and highly stable electrochemical sensing platform for ß-nicotinamide adenine dinucleotide (NADH) based on uncapped Au nanoparticle/reduced graphene oxide (rGO) nanocomposites without the aid of any redox mediators and enzymes. The Au nanoparticle/rGO composite sensing platform was directly formed on a glassy carbon electrode through an in situ electrochemical reduction of GO and Au(3+) with a 100% usage of the precursors. The as-prepared Au nanoparticle/rGO composites demonstrated excellent direct electrocatalytic oxidation toward NADH, providing a large electrochemical active surface area as well as a favorable environment for electron transfer from NADH to the electrode via the enhanced mobility of charge carriers. The Au nanoparticle/rGO composites offered a ~2.3 times higher electrocatalytic current density with a negative shift of 112mV, in comparison to Au nanoparticles. The sensor developed in this study displayed a high sensitivity of 0.916µA/µMcm(2) and a wide linear range of from 50nM to 500µM with a limit of detection of 1.13nM (S/N=3). The interferences from the common interferents such as glutathione, glucose, ascorbic acid and quanine were negligible. The prepared sensor was further tested for the determination of NADH in human urine samples, showing the Au nanoparticle/rGO nanocomposites simultaneously formed by one-step electrochemical reduction have promising biomedical applications.

Application of CdO nanoparticle ionic liquid modified carbon paste electrode as a high sensitive biosensor for square wave voltammetric determination of NADH.

In this paper we report the synthesis and application of CdO nanoparticle (CdO/NPs) and 1,3-dipropylimidazolium bromide as high sensitive sensors for voltammetric determination of nicotinamide adenine dinucleotide (NADH) using carbon paste electrode. The cyclic voltammogram showed an irreversible oxidation peak at 0.68 V (vs. Ag/AgClsat), which corresponded to the oxidation of NADH. Compared to common carbon paste electrode, the electrochemical response was greatly improved for NADH electrooxidation at a surface of CdO/NP modified ionic liquid carbon paste electrode (IL/CdO/NP/CPE). The linear response range and detection limit were found to be 0.09-750 µmol L(-1) and 0.05 µmol L(-1), respectively. Result shows that other physiological species did not interfere in the determination of NADH at the surface of the proposed sensor in the optimum condition. The proposed sensor was successfully applied for the determination of NADH in tap water, urine and pharmaceutical serum samples.

A novel modified carbon paste electrode based on NiO/CNTs nanocomposite and (9, 10-dihydro-9, 10-ethanoanthracene-11, 12-dicarboximido)-4-ethylbenzene-1, 2-diol as a mediator for simultaneous determination of cysteamine, nicotinamide adenine dinucleotide and folic acid.

A carbon paste electrode (CPE) modified with (9, 10-dihydro-9, 10-ethanoanthracene-11, 12-dicarboximido)-4-ethylbenzene-1, 2-diol (DEDE) and NiO/CNTs nanocomposite was used for the sensitive voltammetric determination of cysteamine (CA), nicotinamide adenine dinucleotide (NADH) and folic acid (FA) for the first time. The synthesized materials were characterized with different methods such as XRD, cyclic voltammetry, electrochemical impedance spectroscopy (EIS) and square wave voltammetry (SWV). The modified electrode exhibited a potent and persistent electron mediating behavior followed by well-separated oxidation peaks of CA, NADH and FA. The peak currents were linearly dependent on CA, NADH and FA concentrations using square wave voltammetry (SWV) method in the ranges of 0.01-250, 1.0-500, and 3.0-550 µmol L⁻¹, with detection limits of 0.007, 0.6, and 0.9 µmol L⁻¹, respectively. The modified electrode was used for the determination of CA, NADH and FA in biological and pharmaceutical samples.

Characterization and diagnosis of cancer by native fluorescence spectroscopy of human urine.

Urine is one of the diagnostically important bio fluids, as it has different metabolites in it, where many of them are native fluorophores. Native fluorescence characteristics of human urine samples were studied using excitation-emission matrices (EEMs) over a range of excitation and emission wavelengths, and emission spectra at 405 nm excitation, to discriminate patients with cancer from the normal subjects. The fluorescence spectra of urine samples of cancer patients exhibit considerable spectral differences in both EEMs and emission spectra with respect to normal subjects. Different ratios were calculated using the fluorescence intensity values of the emission spectra and they were used as input variables for a multiple linear discriminant analysis across different groups. The discriminant analysis classifies 94.7% of the original grouped cases and 94.1% of the cross-validated grouped cases correctly. Based on the fluorescence emission characteristics of urine and statistical analysis, it may be concluded that the fluorophores nicotinamide adenine dinucleotide (NADH) and flavins may be considered as metabolomic markers of cancer.

A novel metabolite of antituberculosis therapy demonstrates host activation of isoniazid and formation of the isoniazid-NAD+ adduct.

One of the most effective and widely used antituberculosis (anti-TB) drugs is isoniazid (INH), a prodrug activated via oxidation that forms an adduct with NAD(+) to inhibit NADH-dependent targets of Mycobacterium tuberculosis, such as enoyl-acyl carrier protein reductase (InhA). The metabolic by-products and potentially toxic intermediates resulting from INH therapy have been identified through a large body of work. However, an INH-NAD adduct or structures related to this adduct have not been identified in specimens from human TB patients or animal models of TB. Analyses by mass spectrometry of urine collected from TB patients in a study conducted by the NIAID-funded Tuberculosis Research Unit identified 4-isonicotinoylnicotinamide (C(12)H(9)N(3)O(2)) as a novel metabolite of INH therapy. This compound was formed by M. tuberculosis strains in a KatG-dependent manner but could also be produced by mice treated with INH independent of an M. tuberculosis infection. Thus, the 4-isonicotinoylnicotinamide observed in human urine samples is likely derived from the degradation of oxidized INH-NAD adducts and provides direct evidence of host INH activation.

Consideration of diurnal variations in human blood NAD and NADP concentrations.

The sum of the urinary excretion of nicotinamide and its catabolites, which are metabolites of NAD and NADP, were observed to have clear diurnal variations in human urine. Then, we examined whether NAD and NADP in blood also showed the diurnal variation. All subjects were housed in the same facility and given the same diet during the experiment. In addition, we examined whether diurnal variations were affected by the intakes of dietary nicotinamide or not. As a result, neither the NAD nor the NADP content of the blood shows the diurnal variation regardless of the administered amount of nicotinamide. The concentrations of NAD and NADP did not increase according to the intake of nicotinamide. The existence of a mechanism by which NAD and the NADP levels of the blood are constantly maintained by the adjustment of the amount of excretion to the urinary bladder, was suggested.

Whole blood NAD and NADP concentrations are not depressed in subjects with clinical pellagra.

Population surveys for niacin deficiency are normally based on clinical signs or on biochemical measurements of urinary niacin metabolites. Status may also be determined by measurement of whole blood NAD and NADP concentrations. To compare these methods, whole blood samples and spot urine samples were collected from healthy subjects (n = 2) consuming a western diet, from patients (n = 34) diagnosed with pellagra and attending a pellagra clinic in Kuito (central Angola, where niacin deficiency is endemic), and from female community control subjects (n = 107) who had no clinical signs of pellagra. Whole blood NAD and NADP concentrations were measured by microtiter plate-based enzymatic assays and the niacin urinary metabolites 1-methyl-2-pyridone-5-carboxamide (2-PYR) and 1-methylnicotinamide (1-MN) by HPLC. In healthy volunteers, inter- and intra-day variations for NAD and NADP concentrations were much lower than for the urinary metabolites, suggesting a more stable measure of status. However, whole blood concentrations of NAD and NADP or the NAD:NADP ratio were not significantly depressed in clinical pellagra. In contrast, the concentrations of 2-PYR and 1-MN, expressed relative to either creatinine or osmolality, were lower in pellagra patients and markedly higher following treatment. The use of the combined cut-offs (2-PYR <3.0 micromol/mmol creatinine and 1-MN <1.3 micromol/mmol creatinine) gave a sensitivity of 91% and specificity of 72%. In conclusion, whole blood NAD and NADP concentrations gave an erroneously low estimate of niacin deficiency. In contrast, spot urine sample 2-PYR and 1-MN concentrations, relative to creatinine, were a sensitive and specific measure of deficiency.

Liquid chromatographic/mass spectrometric procedure for measurement of NAD catabolites in human and rat plasma and urine.

Monitoring level of the metabolites of the coenzyme NAD such as nicotinamide and its oxidized and methylated derivatives is important due to therapeutic applications of these compounds and monitoring of oxidative stress. We evaluated feasibility of using HPLC with electrospray ion-trap mass detection for single run separation and quantitation of all the NAD metabolites. We achieved good separation and retention of all the metabolites of interest using reversed-phase with ion-pairing. Single ion monitoring or tandem MS were used for detection and quantitation of the specific compounds with good linearity. The method was able to detect all the physiological metabolites in plasma samples of rats and humans or in urine. However, full validation is necessary before this method could be routinely applied.

Detection of urinary tract infections by reduction of nitroblue tetrazolium.

BACKGROUND: Nitroblue tetrazolium (NBT) reduction to formazan has been used as a marker for nitric oxide synthase (NOS). Since inducible NOS activity is elevated in urine from patients with urinary tract infections (UTIs), we investigated the accuracy of NBT reduction as an early predictor of UTIs and quantified the relationship between inducible NOS and NBT. METHODS: Urine samples from 434 patients were screened for the presence of UTIs with leukocyte-esterase and nitrite dipsticks and with NBT reduction. The rapid screening results from each test were compared to urine culture results. In addition, NBT reduction parameters were measured in urine pellet at 595 nm after incubation with one of four factors: NOS cofactors, NOS inhibitors, NADH, or superoxide dismutase/catalase. RESULTS: As a urine screening test for UTIs, NBT reduction was more sensitive with a higher negative predictive accuracy than the nitrite dipstick. NBT reduction also was more specific with a higher positive predictive accuracy and negative predictive accuracy than the leukocyte-esterase dipstick. In infected urine pellet, both NADPH, a NOS cofactor, and NADH increased NBT reduction. Superoxide dismutase/catalase decreased NBT reduction. CONCLUSIONS: Although NOS may not be the only NBT reducing enzyme, rapid, visible reduction of NBT is induced in urine from patients with UTIs.

[Determination of N'methylnicotinamide and nicotine coenzymes in biological in biological media by the fluorescent method]. / Opredelenie N'-metilinkotinamida i nikotinovykh kofermentov v biologicheskikh sredakh fliuorestsentnym metodom.

Assay of N1-MNA was conducted in 96 urine samples using two methodological variants with external and internal N1-MNA standards. Basing on significant fluctuations of the percent of detecting N1-MNA added to urine, the necessity of using the internal standard was proved. A significant (up to 30%) overestimating of the values in using the external standard makes difficult revealing niacin deficiency. It has been recommended that NAD preparation be used as an internal standard in NAD + NADP assay in the blood, that permits one to simplify significantly the counting and to avoid the universal coefficient (used in literature) of recalculating N1-MNA fluorescence to nicotinamide coenzyme fluorescence because this coefficient is not a constant value.