D-Ribose as a Supplement for Cardiac Energy Metabolism

Abstract

Metabolic support for the heart has been an attractive concept since the pioneering work of Sodi-Pallares et al. four decades ago.* Recently, interest has increased in the use of over-the-counter supplements and naturally occurring nutriceuticals for enhancement of cardiac and skeletal muscle performance. These include amino acids such as creatine, L-carnitine, and L-arginine, as well as vitamins and cofactors such as alpha-tocopherol and coenzyme Q. Like these other molecules, D-ribose is a naturally occurring compound. It is the sugar moiety of ATP and has also received interest as a metabolic supplement for the heart. The general hypothesis is that under certain pathologic cardiac conditions, nucleotides (particularly ATP, ADP, and AMP) are degraded and lost from the heart. The heart's ability to resynthesize ATP is then limited by the supply of D-ribose, which is a necessary component of the adenine nucleotide structure. In support of this hypothesis, recent reports have used D-ribose to increase tolerance to myocardial ischemia. Its use in patients with stable coronary artery disease improves time to exercise-induced angina and electrocardiographic changes. In conjunction with thallium imaging or dobutamine stress echocardiography, D-ribose supplementation has been used to enhance detection of hibernating myocardium. In this article, we review the biochemical basis for using supplemental D-ribose as metabolic support for the heart and discuss the experimental evidence for its benefit.

D-Ribose Ameliorates Cisplatin-Induced Nephrotoxicity by Inhibiting Renal Inflammation in Mice

“…D-ribose is another naturally occurring five-carbon monosaccharide that is found in all living cells. It is the sugar moiety of adenosine triphosphate (ATP), therefore, it has been investigated as a potential metabolic supplement for the heart (Pauly and Pepine 2000). We have previously demonstrated that D-ribose has anti-inflammatory effects in renal ischemia/reperfusion injury (Nishiyama et al 2009;Sato et al 2009).…”

Protective Action of D-Ribose against Renal Injury Caused by Ischemia and Reperfusion in Rats with Transient Hyperglycemia

“…Among familiar monosaccharides, D-ribose is a naturally occurring five-carbon monosaccharide that is found in all living cells. As it is the sugar moiety of ATP, it has been investigated as a potential metabolic supplement for the heart (Pauly and Pepine 2000). We also demonstrated that D-ribose attenuated I/R-induced renal injury by reducing neutrophil activation in normoglycemic rats (Sato et al 2009).…”

D-Ribose Attenuates Ischemia/Reperfusion-Induced Renal Injury by Reducing Neutrophil Activation in Rats

“…D-ribose is a naturally occurring fivecarbon monosaccharide that is found in all living cells. As it is the sugar moiety of ATP, it has been investigated as a potential metabolic supplement for the heart (Pauly and Pepine 2000). The inhibitory effect of activation of neutrophil of D-ribose on renal I/R is almost same potency compared with that of D-allose.…”

“…D-ribose is another naturally occurring fivecarbon monosaccharide that is found in all living cells and is cheap when compared with D-allose. As it is the sugar moiety of ATP, it has been investigated as a potential metabolic supplement for the heart (Pauly and Pepine 2000). This study was therefore designed to investigate the possi-bility that D-ribose attenuates I/R-induced renal injury by inhibiting neutrophil activation and/or infiltration.…”