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Mitochondria have long been known as intracellular organelles that play a central role in energy metabolism by producing adenosine triphosphate (ATP) through oxidative phosphorylation (OXPHOS), the TCA cycle, and beta-oxidation of fatty acids. Furthermore, mitochondria are thought to be involved in various biological aspects related to aging, such as the production of reactive oxygen species (ROS), genome stability, mitochondrial DNA (mtDNA) replication, mitophagy, telomere function, and cellular aging. These mitochondrial functions decline with aging and have been reported by various researchers to underlie the pathogenic mechanisms of age-related diseases such as diabetes, chronic kidney disease, heart failure, and Alzheimer’s disease [1]. It has also been suggested that mitochondria mediate the benefits of calorie restriction, which delays the onset of age-related diseases and extends the lifespan of the individual, thus increasing the importance of mitochondrial research in anti-aging medicine.

Nicotinamide adenine dinucleotide (NAD+) was discovered in 1906 by British biochemist Dr. Arthur Harden and has long been known as a coenzyme that plays an important role in redox reactions. In 2000, the NAD + -dependent deacetylase activity of the aging and lifespan control factor sirtuin was discovered by Imai and Guarente at the Massachusetts Institute of Technology, leading to a dramatic development in NAD+ biology research. As a result, it is suggested that a decrease in NAD+ levels contributes to the molecular mechanisms of aging through a decrease in sirtuin activity, and also plays a part in the pathogenesis of various aging-related diseases such as diabetes, chronic kidney disease, heart failure, and Alzheimer’s disease. Currently, with about 115 years of history, NAD+ biology research is entering a second golden (renaissance) period centered on two NAD+ metabolic intermediates, nicotinamide mononucleotide (NMN) and nicotinamide riboside (NR), and it is no exaggeration to say that it is forming the mainstream of aging and lifespan research and antiaging medicine [1, 2].