• D-ribose is a natural pentose sugar

• D-ribose is a structural component of DNA, RNA, GTP, flavins (FAD, riboflavin) and other important nucleotides found in all living cells.
  
              

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• Purine nucleotides (ATP and its precursors lost due to ischemica, hypoxia, or genetic predisposition are replaced via the purine nucleotide pathway. Pathway I is rate limited by the availability of ribose in tissue.
  
  





• Ribose is formed naturally via the pentose phosphate pathway. This pathway is very slow and energy is insufficient in cardiac and skeletal muscle due to an inherently low concentration (lack of expression) of driver enzymes, especially glucose-6-phosphate dehydrogenase. The product of this pathway is ribose-5-phosphate, which in turn is converted to 5-phosphoribosyl-1-pyrophosphate (PRPP), the primary driver in the formation of new purine nucleotides. No other pentose sugar or other compound lends itself to the adenine nucleotide synthetic or salvage pathways.





• Administration of exogenous ribose, bypasses the rate-limiting steps in the pentose phosphate pathway, resulting in a significant acceleration in purine nucleotide synthesis (pathway II).
  
  





• This increased concentration of ATP is accompained by an increased energy potential in the cell, also known as the "energy charge".





• Cardiac and skeletal muscle functions (i.e. concentration, cell wall maintenance, relaxation, polarization of the cell membrane, etc.) each require a different, quantifiable energy charge to fuel or provide allosteric regulation of each function. Restoration of cellular energy charge restores function consistent with the degree of energy charge restored.

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• D-ribose is rapidly absorbed across the gut reaching peak blood levels within 30-45 minutes.





• D-ribose is absorbed into muscle tissue and is phosphorylated by ribokinase as it crosses the cell membrane becoming Ribose-5-phosphate.





• Ribose not taken up by cellular tissues to excreted unchanged in the urine.

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• Congestive heart failure.





• Chronic ischemic heart diseases.





• Open-heart surgical procedures both to stabilize and energize the heart pre-op and to accelerate recovery post-op.





• Post MI event to re-energize the heart and minimize cell damaze due to lost ATP.





• Identifying hibernating myocardium in conjunction with accepted diagnostic procedure.





• Acute or chrnic ATP deficiencies in muscle tissue in diseases such as fibromyalgia, chronic fatigue.

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• Mild, transient hypoglycemia; ribose may down-regulate phosphoglucomutase, a liver enzyme responsible for glycogen mobilization.





• GI symptoms are mild and consistent with placebo.





• Insulin dependent and diabetics and pregnant women should consult their physician.

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• None

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• None Known

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