Complications
Neurologic features of pellagra include weakness and paralysis of the extremities. They can also include insomnia, depression, or memory loss as well as intermittent stupor, hallucinations, or delirium.
These features include cogwheel rigidity, primitive reflexes (grasping and sucking), ataxia, and incontinence.
Niacin status has an influence on DNA repair, genomic stability, and the immune system. This in turn has an impact on cancer risk and on the adverse effects of chemotherapy.[35][94][95][96]
The nicotinamide adenosine dinucleotide (NAD) content of cells influences the synthesis of ADP-ribose polymers that play a role in DNA repair as NAD is a substrate in ADP-ribose reactions. Poly(ADP-ribose) polymerase-1 is an enzyme activated by DNA strand breaks. It is responsible for the majority of polymer synthesis and plays an important role in DNA repair, genomic stability, and signaling events for stress responses.[97]
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