Chemotherapy accelerated bone ageing is reversed by NMN
Cancer patients face an array of long-term chronic diseases and accelerated biological ageing, due largely to the off-target effects of broadly cytotoxic chemotherapy drugs. This is especially a problem in children, where cancer survivors experience a subsequent high risk of bone mineral deficits and fractures, normally seen in the older population. Here, we model this to show that early-life treatment with a single dose of the commonly used chemotherapy cisplatin profoundly impairs late-life bone health, and that these bone deficits are completely resolved through treatment with the nicotinamide adenine dinucleotide (NAD+) precursor nicotinamide mononucleotide (NMN). While we had previously shown that this same strategy protects against chemotherapy induced female infertility, this maintenance of aged bone health appears to be unrelated to endocrine changes due to protection of the ovarian reserve. Rather, this is driven by altered phosphorus homeostasis and protection against renal damage, which otherwise increases parathyroid hormone secretion to mobilise calcium stores from bone. Overall, this work highlights a new approach for maintaining healthy bone ageing in cancer survivors.