This study was designed to examine activity of AMP-activated protein kinase kinase (AMPKK) and AMP-activated protein kinase (AMPK) in muscles from control (C) and endurance trained (T) rats. Rats were trained 5 days/wk, 2 hr/d for 8 wks at a final intensity of 32 m/min up a 15% grade with 30 second sprints at 52 m/min every 10 min. Gastrocnemius muscles were stimulated in situ in T and C rats for 5 min at frequencies of 0.4/sec and 1/sec. Gastrocnemius LKB1 protein, a putative component of the AMPKK complex (LKB1, STRAD, and MO25), increased approximately 2-fold in response to training. Phosphorylation of AMPK determined by western blot was increased at both stimulation rates in both control and trained rats. AMPK activity of both the α1 and α2 isoforms (immunoprecipitates) also increased at both stimulation rates in both C and T rats. AMPKK activity was strikingly lower in both resuspended polyethylene glycol (PEG) precipitates and 1200 x g supernatant of the crude homogenate of muscle extracts from the trained compared to control rats. AMPKK activity did not increase in either T or C in response to electrical stimulation even though phospho-AMPK did increase. Interestingly, AMPKK activity in the 1200 x g supernatant of the crude homogenate actually decreased upon stimulation in the control rats. These results suggest that AMPKK is activated during electrical stimulation by mechanisms other than covalent modification. Possibilities include AMP-induced optimization of the phosphorylation site on the target protein, contraction-induced changes in undefined allosteric modulators, and contraction-induced association with other proteins. (Study approved by the IACUC and supported by NIH RO1 AR41438.)

Studies have shown that following bariatric surgery, there is an almost immediate reversal of type 2 diabetes. However, there still remains questions as to why this occurs and what possible explanations there may be. This paper aims to focus on several studies that have found a reversal of diabetes in obese patients who have undergone bariatric surgery. Furthermore, it explores several possibilities for the reasons behind this reversal including the role of AMP-activated protein kinase, the incretins gastric inhibitory peptide and glucagon-like peptide-1, and also looks at genetics. Bariatric surgery and a description of certain mechanisms are first described for an understanding. Following is a literature review of published studies on bariatric surgery, the reversal of diabetes following the procedure, and roles of AMPK and incretins. Because of the possibility that reduced caloric intake may not be the major factor in the diabetic reversal, it is suggested that further research be done on obese and normal weight patients and observe the levels of the mentioned mechanisms and also various genes to see if they offer a more thorough explanation.

Sorafenib is a multi-kinase inhibitor and one of the few systemic treatment options for patients with advanced hepatocellular carcinomas (HCCs). Resistance to sorafenib develops frequently and could be mediated by the nicotinamide adenine dinucleotide (NAD)-dependent deacetylase sirtuin (SIRT)1. We aimed to test whether sorafenib efficacy is influenced by cellular NAD levels and NAD-dependent SIRT1 function. We analyzed sorafenib effects on apoptosis induction, NAD salvage, mitochondrial function, and related signaling pathways in HCC cell lines (HepG2, Hep3B, und HUH7) overexpressing SIRT1 or supplemented with the NAD metabolite nicotinamide mononucleotide (NMN) compared to controls. Treatment of HCC cell lines with sorafenib dose-dependently induced apoptosis and a significant decrease in cellular NAD concentrations. The SIRT1 protein was downregulated in HUH7 cells but not in Hep3B cells. After sorafenib treatment, mitochondrial respiration in permeabilized cells was lower, citrate synthase activity was attenuated, and cellular adenosine triphosphate (ATP) levels were decreased. Concomitant to increased phosphorylation of adenosine monophosphate (AMP)-activated protein kinase (AMPK), sorafenib treatment led to decreased activity of the mechanistic target of rapamycin (mTOR), indicative of energy deprivation. Transient overexpression of SIRT1, as well as NAD repletion by NMN, decreased sorafenib-induced apoptosis. We can, therefore, conclude that sorafenib influences the NAD/SIRT1/AMPK axis. Overexpression of SIRT1 could be an underlying mechanism of resistance to sorafenib treatment in HCC

京都大学 / 新制・課程博士 / 博士(医学) / 甲第25000号 / 医博第5034号 / 新制||医||1070(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 長船 健二, 教授 尾野 亘, 教授 江藤 浩之 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

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京都大学 / 新制・課程博士 / 博士(医学) / 甲第23805号 / 医博第4851号 / 新制||医||1058(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 長船 健二, 教授 寺田 智祐, 教授 稲垣 暢也 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Cholesterol and fatty acid homeostasis is maintained by a complex network of regulatory mechanisms that control the biosynthesis and deposition of lipids over diverse physiological conditions. However, these processes can become dysregulated and uncoupled from energy metabolism by metabolic stress such as a hyper-caloric diet and physical inactivity; eventually manifesting as risk factors associated with atherosclerotic cardiovascular disease (ASCVD), Type 2 diabetes (T2D), and/or non-alcoholic fatty liver disease (NAFLD). AMP-activated protein kinase (AMPK) is a sensor of cellular energy status that promotes metabolic homeostasis by mediating effects on multiple cellular processes including cholesterol and fatty acid synthesis biosynthesis. However, the mechanisms linking AMPK to lipid metabolism under normal and pathological conditions, remain undefined. In these studies, we identify a novel nutrient sensing mechanism whereby the coenzyme A (CoA) activated esters of long-chain fatty acids (LCFA-CoA) directly activate AMPK via specific interactions within the β1-regulatory subunit involving a Ser108 residue previously shown only with synthetic activators. We demonstrate the physiological relevance for this mechanism in an acute setting by showing that fatty acid oxidation was attenuated in mice harboring an AMPKβ1-S108A knock-in mutation compared to WT mice. We then demonstrated that β1-selctive AMPK activation is mimicked by the CoA conjugated form of bempedoic acid, a synthetic small molecule lipid synthesis inhibitor in clinical development for lowering elevated levels of low-density lipoprotein cholesterol (LDL-C). The importance of this mechanism was determined by assessing multiple disease outcomes in Ampkβ1-/-/Apoe-/- double knockout (DKO) mice fed a high fat-high cholesterol (HFHC) diet ± bempedoic acid. In these studies, bempedoic acid treatment reduced plasma LDL-C and atherosclerosis in both Apoe-/- and DKO mice, while no differences in disease outcomes was detected between the two genotypes in response to HFHC feeding. Further mechanistic investigations in rodent and primary human hepatocytes, revealed that the CoA conjugate of bempedoic acid suppressed lipid synthesis via competitive inhibition of ATP-citrate lyase (ACL), which promoted LDL receptor upregulation and associated reductions in LDL-C. We then integrate these findings with published literature in a written synthesis aimed to evaluate the role of ACL in metabolism, and its potential utility as a therapeutic target to treat ASCVD and metabolic disorders in humans. Although several questions remain regarding the metabolic role of AMPK activation by LCFA-CoAs, these studies have expanded our understanding of how cells acutely integrate lipid and energy signals to maintain lipid homeostasis, and identified ACL as a promising strategy to treat hypercholesterolemia, ASCVD, and associated metabolic disorders. / Thesis / Doctor of Philosophy (PhD) / The dysregulation of cholesterol and triglyceride metabolism can manifest as risk factors for life-threating diseases such as atherosclerotic cardiovascular diseases (ASCVD), Type-2 diabetes (T2D), and nonalcoholic fatty liver disease (NAFLD). However, the underlying mechanisms controlling lipid homeoastasis in health and disease are not completely understood. ATP-citrate lyase (ACL) and AMP-activated protein kinase (AMPK) are emerging as key nodes in metabolism that integrate lipid metabolism with signals of nutrient availability and cellular energy status, respectively. These strategic positions in metabolism suggest that both these enzymes could play an important role in the underlying pathophysiology of lipid-related diseases, and are therefore, prime candidates for therapeutic intervention. In these studies, we expand our understanding of the role of AMPK in metabolism beyond energy sensing by identifying specific lipid metabolites as direct allosteric activators of kinase activity. We also evaluate the therapeutic utility of targeting both AMPK and ACL in novel models of hypercholesterolemia and metabolic disease, and demonstrate that ACL inhibition offers a promising strategy to address multiple unmet medical needs.