Differentially disrupted spinal cord and muscle energy metabolism in spinal and bulbar muscular atrophy

Prior studies showed that polyQ-expanded AR is aberrantly acetylated and that deacetylation of the mutant AR by overexpression of NAD+-dependent sirtuin 1 (SIRT1) is protective in cell models of spinal and bulbar muscular atrophy (SBMA). Based on these observations and reduced NAD+ in muscles of SBMA mouse models, we tested the therapeutic potential of NAD+ restoration in vivo by treating post-symptomatic transgenic SBMA mice with the nicotinamide adenine dinucleotide (NAD+) precursor nicotinamide riboside (NR). NR supplementation failed to alter disease progression and had no effect on increasing NAD+ or ATP content in muscle, despite producing a modest increase of NAD+ in the spinal cord of SBMA mice. Metabolite and proteomic profiles of SBMA quadriceps muscles indicated alterations in several important energy-related pathways that utilize NAD+, in addition to the NAD salvage pathway, which is critical for NAD+ regeneration for use in cellular energy production. We also observed decreased mRNA levels of Nmrk2, which encodes a key kinase responsible for NR phosphorylation, allowing its utilization by the NAD salvage pathway. Together these data suggest a model in which NAD+ levels are significantly decreased in muscles of an SBMA mouse model and intransigent to NR supplementation due to decreased levels of Nmrk2.