Druggability & Clinical Context
Druggability
Medium
Score: 0.61
Druggability Analysis
Structural Tractability0.85
Key Metrics
PDB Structures:
30
Known Drugs:
4
Approved:
0
In Clinical Trials:
0
Drug Pipeline (4 compounds)
Therapeutic Areas:Alzheimer's disease Parkinson's disease Neurodegeneration Mitochondrial dysfunction Oxidative stress-related disorders Age-related cognitive decline Neuroinflammation
Druggability Rationale: SIRT3 is moderately tractable (0.68 score) as an enzyme target with a well-characterized NAD+-binding pocket and established precedent for activation via both direct small-molecule activators (Honokiol) and indirect NAD+ precursor approaches (NR, NMN). The existence of clinical-stage compounds and the target's clear enzymatic mechanism support small-molecule druggability, though achieving selective SIRT3 activation over other sirtuins remains a key challenge.
Mechanism: Enzyme activation — enhancing SIRT3 deacetylase activity restores mitochondrial protein function and reduces oxidative stress
Drug Pipeline (4 compounds)
Known Drugs:Nicotinamide Riboside (NR) (Clinical trials)
Nicotinamide Mononucleotide (NMN) (Clinical trials)
Honokiol (Preclinical)
Resveratrol (Phase II)
Structural Data:PDB (30) ✓AlphaFold ✓Cryo-EM —
Binding Pocket Analysis:SIRT3 contains a conserved NAD+-binding pocket characteristic of the sirtuin family, with the catalytic domain accommodating both NAD+ cofactor and acetylated protein substrates. Direct activators likely bind allosteric sites distinct from the NAD+ pocket, while NAD+ precursors work by increasing local NAD+ availability rather than direct binding.
Selectivity & Safety Considerations
SIRT3 selectivity is challenging due to structural homology with other NAD+-dependent sirtuins (SIRT1, SIRT4, SIRT5); off-target effects on cytoplasmic sirtuins could confound mitochondrial-specific outcomes. Mitochondrial localization provides a degree of inherent selectivity advantage, allowing indirect activation via NAD+ precursors to preferentially benefit SIRT3 without requiring direct isoform selectivity.
Clinical Trials (8)
Relevant trials from ClinicalTrials.gov
By Phase
NA: 4 · PHASE1: 3 · PHASE3: 1
PHASE1
NCT06566443
n=15
Carcinoma, Non-Small-Cell Lung
Interventions: Honokiol
Sponsor: The Methodist Hospital Research Institute | Started: 2024-11-08
NA
NCT06481696
n=90
Unexplained Infertility
Interventions: Resveratrol-based multivitamin supplemen, Folic acid, IVF/ICSI
Sponsor: Andros Day Surgery Clinic | Started: 2024-06-01
PHASE3
NCT06775314
n=102
Acne Vulgaris
Interventions: Cleanser, Combination cream, spot cream
Sponsor: Dr.dr.Irma Bernadette, SpKK (K) | Started: 2025-03-01
NA
NCT07284225
n=20
Healthy Volunteers
Interventions: Nicotinamide Riboside (NR), Placebo
Sponsor: Eye & ENT Hospital of Fudan University | Started: 2025-12-20
NA
NCT06790771
n=25
Hunger
Interventions: High Dose Supplement, Low Dose Supplement, Placebo
Sponsor: Texas Christian University | Started: 2025-01-15
PHASE1
NCT03789175
n=1
Cancer, Skin Fibroblasts, Muscle Weakness
Interventions: Nicotinamide Riboside (NR)
Sponsor: National Heart, Lung, and Blood Institute (NHLBI) | Started: 2019-03-25
PHASE1
NCT05698771
n=12
Healthy
Interventions: Nicotinamide Riboside (NR), nicotinamide mononucleotide, Nicotinamide Riboside (NR)
Sponsor: Haukeland University Hospital | Started: 2022-09-17
NA
NCT02129595
n=15
Pre-diabetes
Interventions: placebo, resveratrol
Sponsor: Maastricht University Medical Center | Started: 2014-04