A Potent and Specific CD38 Inhibitor Ameliorates Age-Related Metabolic Dysfunction by Reversing Tissue NAD+ Decline

Cell Metab. 2018 May 1;27(5):1081-1095.e10. doi: 10.1016/j.cmet.2018.03.016.


Aging is characterized by the development of metabolic dysfunction and frailty. Recent studies show that a reduction in nicotinamide adenine dinucleotide (NAD+) is a key factor for the development of age-associated metabolic decline. We recently demonstrated that the NADase CD38 has a central role in age-related NAD+ decline. Here we show that a highly potent and specific thiazoloquin(az)olin(on)e CD38 inhibitor, 78c, reverses age-related NAD+ decline and improves several physiological and metabolic parameters of aging, including glucose tolerance, muscle function, exercise capacity, and cardiac function in mouse models of natural and accelerated aging. The physiological effects of 78c depend on tissue NAD+ levels and were reversed by inhibition of NAD+ synthesis. 78c increased NAD+ levels, resulting in activation of pro-longevity and health span-related factors, including sirtuins, AMPK, and PARPs. Furthermore, in animals treated with 78c we observed inhibition of pathways that negatively affect health span, such as mTOR-S6K and ERK, and attenuation of telomere-associated DNA damage, a marker of cellular aging. Together, our results detail a novel pharmacological strategy for prevention and/or reversal of age-related NAD+ decline and subsequent metabolic dysfunction.

Keywords: CD38; NAD(+); SIRTUINS; acetylation; aging; exercise capacity; glucose; progeroid; skeletal muscle.

MeSH terms

  • ADP-ribosyl Cyclase 1 / antagonists & inhibitors*
  • AMP-Activated Protein Kinase Kinases
  • Aging / drug effects*
  • Aging / metabolism
  • Animals
  • Cellular Senescence / drug effects*
  • DNA Damage / drug effects
  • Enzyme Inhibitors / chemistry
  • Enzyme Inhibitors / pharmacology*
  • Glucose Intolerance / blood
  • Glucose Intolerance / drug therapy
  • Humans
  • MAP Kinase Signaling System / drug effects
  • Mice
  • NAD / metabolism*
  • Physical Functional Performance
  • Poly(ADP-ribose) Polymerases / metabolism
  • Protein Kinases / metabolism
  • Quinolines / chemistry
  • Quinolines / pharmacology*
  • Sirtuins / metabolism
  • TOR Serine-Threonine Kinases / metabolism
  • Triazoles / chemistry
  • Triazoles / pharmacology*


  • Enzyme Inhibitors
  • Quinolines
  • Triazoles
  • NAD
  • Poly(ADP-ribose) Polymerases
  • Protein Kinases
  • mTOR protein, mouse
  • TOR Serine-Threonine Kinases
  • AMP-Activated Protein Kinase Kinases
  • ADP-ribosyl Cyclase 1
  • Sirtuins