Boosting a Specific Nutrient may Help Treat Scleroderma

by Karishma Abhishek on Jan 22 2021 5:57 AM

Boosting a Specific Nutrient may Help Treat Scleroderma
Pathology of scleroderma – a chronic and incurable orphan disease (currently), remains poorly understood. Irreversible and progressive skin and internal organs scarring are the defining characteristics of systemic sclerosis – the most serious form of scleroderma.
The causes of this disabling scarring that occur in the disease are explored by the study done by Michigan Medicine's Scleroderma Program and the rheumatology and dermatology departments partnered with the Northwestern Scleroderma Program in Chicago and Mayo Clinic.

Human patient samples, preclinical mouse models, and explanted human skin were investigated by the team, as published in the journal iScience.

The treatment of scleroderma

"We found that scleroderma inflammation dramatically increases CD38, an enzyme that normally breaks down a metabolic nutrient, NAD+. When NAD+ levels decrease, tissue injury becomes chronic and progresses to scar formation rather than to healthy repair," says study author John Varga, M.D., division chief of rheumatology at Michigan Medicine.

Thus the study states that scarring in the skin, lungs, and the abdominal wall is prevented by the treatment that acts against NAD+ reduction in the mice, either by boosting the levels of the nutrient genetically or pharmacologically.

Role of a safe and inexpensive dietary supplement – precursor nicotinamide riboside in boosting NAD+ helps prevent skin and another organ scarring. This sheds light on exploring the undiscovered pathogenic role of CD38 in scleroderma scarring.

"These results open the door to entirely novel treatments for fibrosis and scleroderma. Using precision medicine, these treatments could be selectively targeted to block CD38 in scleroderma patients who have elevated CD38," says study author Bo Shi, Ph.D., a research assistant professor of dermatology at Northwestern Medicine.

The present study highlights the use of pre-existing drugs or well-tolerated dietary supplements for restoring levels of NAD+. Both of these therapeutic approaches are entirely novel strategies to halt scleroderma's most debilitating side effect.

Further clinical trials are required to assess the safety, tolerability and efficacy of these innovative treatments in scleroderma patients.