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Nicotinamide riboside (NR) has emerged as a promising therapeutic NAD\n                    <jats:sup>+<\/jats:sup>\n                    precursor due to efficient NAD\n                    <jats:sup>+<\/jats:sup>\n                    elevation and was recently shown to be the only agent able to reduce cardiac IRI in models employing clinically relevant anesthesia. However, through which metabolic pathway(s) NR mediates IRI protection remains unknown. Furthermore, the influence of insulin, a known modulator of cardioprotective efficacy, on the protective effects of NR has not been investigated. Here, we used the isolated mouse heart allowing cardiac metabolic control to investigate: (1) whether NR can protect the isolated heart against IRI, (2) the metabolic pathways underlying NR-mediated protection, and (3) whether insulin abrogates NR protection. NR protection against cardiac IRI and effects on metabolic pathways employing metabolomics for determination of changes in metabolic intermediates, and\n                    <jats:sup>13<\/jats:sup>\n                    C-glucose fluxomics for determination of metabolic pathway activities (glycolysis, pentose phosphate pathway (PPP) and mitochondrial\/tricarboxylic acid cycle (TCA cycle) activities), were examined in isolated C57BL\/6N mouse hearts perfused with either (a) glucose\u2009+\u2009fatty acids (FA) (\u201cmild glycolysis group\u201d), (b) lactate\u2009+\u2009pyruvate\u2009+\u2009FA (\u201cno glycolysis group\u201d), or (c) glucose\u2009+\u2009FA\u2009+\u2009insulin (\u201chigh glycolysis group\u201d). NR increased cardiac NAD\n                    <jats:sup>+<\/jats:sup>\n                    in all three metabolic groups. In glucose\u2009+\u2009FA perfused hearts, NR reduced IR injury, increased glycolytic intermediate phosphoenolpyruvate (PEP), TCA intermediate succinate and PPP intermediates ribose-5P (R5P) \/ sedoheptulose-7P (S7P), and was associated with activated glycolysis, without changes in TCA cycle or PPP activities. In the \u201cno glycolysis\u201d hearts, NR protection was lost, whereas NR still increased S7P. In the insulin hearts, glycolysis was largely accelerated, and NR protection abrogated. NR still increased PPP intermediates, with now high\n                    <jats:sup>13<\/jats:sup>\n                    C-labeling of S7P, but NR was unable to increase metabolic pathway activities, including glycolysis. Protection by NR against IRI is only present in hearts with low glycolysis, and is associated with activation of glycolysis. When activation of glycolysis was prevented, through either examining \u201cno glycolysis\u201d hearts or \u201chigh glycolysis\u201d hearts, NR protection was abolished. The data suggest that NR\u2019s acute cardioprotective effects are mediated through glycolysis activation and are lost in the presence of insulin because of already elevated glycolysis.\n                  <\/jats:p>","DOI":"10.1007\/s00395-024-01042-4","type":"journal-article","created":{"date-parts":[[2024,3,25]],"date-time":"2024-03-25T13:07:29Z","timestamp":1711372049000},"page":"403-418","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Insulin and glycolysis dependency of cardioprotection by nicotinamide riboside"],"prefix":"10.1007","volume":"119","author":[{"given":"Y.","family":"Xiao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Q.","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Nederlof","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Bakker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. 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