Influence of nicotinamide on glaucoma patients

The literature review dwells on the role of nicotinamide (vitamin B3) in providing neuroprotective and antioxidant protection of the retina in glaucoma optic neuropathy. It presents the data of foreign studies on its positive influence on the condition of retinal ganglion cells and axons of the optic nerve. There is a revival of interest to nicotinamide use in glaucoma in foreign literature of recent years. This is due to its active influence on metabolic processes. As a cofractor of enzymes, it is involved in cell metabolism, tissue respiration, gene expression, redox processes and the repair of deoxyribonucleic acid. Due to direct neuroprotection nicotinamide prevents and slows down the processes that cause apoptosis, such as ischemia, oxidative stress, inflammation, mitochondrial dysfunction, excitotoxicity, impaired axonal transport and loss of neurotrophins. In the central nervous system, vitamin B3 is recognized as a key mediator of the development and survival of neurons. It promotes the differentiation of nerve cells from embryonic stem cells into mature neurons, increases the synaptic plasticity of neurons and promotes the growth of axonal processes. It also shows significant anti-inflammatory, antioxidant and anti-apoptotic effects in various cells and tissues. Nicotinamide counteracts amyloid toxicity and the formation of reactive oxygen species, and its bioavailability plays a crucial role in normal functioning of neurons and in the prevention of neurodegeneration processes.

Particular attention is paid to the antioxidant and neuroprotective role of niacin, as well as its deficiency in neurodegenerative diseases, and other neuropathological conditions. Plasma nicotinamide deficiency was also detected in glaucoma. This allowes suggesting that nicotinamide supplements could be the future therapeutic strategy for glaucoma (as an adjunctive to antihypertensive therapy). It was found that oral administration of niacin has a pronounced neuroprotective effect, protects retinal ganglion cells in chronic ocular hypertension. Niacin consumption correlats with an improvement of vascular endothelium and an oxidative stress reduction. Thus, nicotinamide can be a valuable addition to the antihypertensive therapy of glaucoma and other neurodegenerative diseases, as well as conditions associated with aging.

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