Nicotinamide, a necessary nutrient, has been mainly used to treat niacin deficiency in clinical practice. Recent research on nicotinamide pharmacology has focused on its neuroprotective effects. It has been found that nicotinamide can prevent brain cell necrosis and apoptosis effectively by increasing NAD levels and ATP production, and by inhibiting poly (ADP-ribose) polymerase, membrane phosphatidylserine exposure and DNA fragmentation. As a novel cytoprotectant, nicotinamide plays a critical role in maintaining mitochondrial membrane potential and preventing specific cysteine protease activation. Combined with its effects as an anticonvulsant, anticoagulant and inhibitor of lipid peroxidation, nicotinamide has shown it can be used as a new effective means of inhibiting the development of stroke and rescuing the still viable but injured nerve cells within the ischemic area at an early stage of stroke.
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