Figure 3.

Anticancer effects of nicotinamide and spermidine. Nicotinamide (NAM) protects against DNA damage and oxidative stress, while it improves cancer immunosurveillance, as indicated by an increase in effector T cells, downregulation of immunosuppressive receptors such as lymphocyte-activation gene 3 (LAG3) and T-cell immunoglobulin and mucin-domain containing-3 (TIM3), upregulated macrophage CD36 and phagocyosis. Spermidine affects arginine, methionine, and acetyl-coenzyme A (Acetyl-CoA), stimulates autophagy, and boosts the immunogenicity of dying cancer cells, thus enhancing cytotoxic and memory T-cell responses. ATP, adenosine triphosphate; CD36, scavenger receptor class B member 3; CD39, ecto-nucleoside triphosphate diphosphohydrolase; DCs, dendritic cells, PARP1, poly(ADP-ribose) polymerase 1; SIRT1, sirtuin 1; TOX, thymocyte selection-associated high mobility group box protein.