IGF-1→Tumor Necrosis Factor-alpha→NAD→poly-ADP-ribose

• 20214459(IGF-1): Peripheral neuropathy in chronic obstructive pulmonary disease.

  Peripheral neuropathy was detected at 15 % of chronic obstructive pulmonary disease patients.

• 14680079(Tumor Necrosis Factor-alpha): Cytokines and dietary energy restriction in stable chronic obstructive pulmonary disease patients.

  Tumour necrosis factor (TNF) - alpha has been found to be increased in malnourished chronic obstructive pulmonary disease (COPD) patients ; however , the main cause of this phenomenon remains undetermined.

• 12853070(NAD): Systemic poly(ADP-ribose) polymerase-1 activation, chronic inflammation, and oxidative stress in COPD patients.

  Oxidative stress and systemic inflammation in chronic obstructive pulmonary disease (COPD) strongly suggest a role for the nuclear enzyme poly (ADP-ribose) polymerase-1 (PARP-1 , E.C. 2.4.2.30) in the disease pathophysiology.

• 2940104(poly-ADP-ribose): DNA strand breaks, NAD metabolism, and programmed cell death.

  The balanced DNA excision-repair process is accompanied by a proportional consumption of NAD for poly (ADP-ribose) synthesis.