No description available.

Non-alcoholic fatty liver disease (NAFLD), described by the build-up of excess fat in the liver, is the most prevalent chronic liver condition globally. One of the essential metabolic functions of the liver is the production of ketone bodies, a process called, ketogenesis. Ketone bodies serve as alternative fat-derived sources of fuel for tissues under conditions of nutrient deficit (i.e., fasting). Interestingly, recent studies have found that ketogenesis is dysregulated in NAFLD patients. Similarly, we also found that high-fat diet-induced NAFLD mice exhibited diminished fasting-induced ketogenesis with reduced expression of liver Hmgcs2, the rate-limiting enzyme of ketogenesis. To understand the role of ketogenesis in NAFLD pathogenesis and treatment, we generated mouse models of ketogenic insufficiency and activation through Hmgcs2 loss- and gain-of-function, respectively. Notably, a change in dietary environment rescued the fatty liver phenotype of Hmgcs2 knockout mice and increased ketogenic function through HMGCS2 overexpression improved NAFLD-associated metabolic dysfunction and hepatosteatosis in adult mice. Furthermore, an untargeted metabolomics approach provided a comprehensive metabolic view underlying HMGCS2 overexpression-mediated NAFLD improvement, suggesting that hepatic ketogenesis impacts liver metabolism via regulation of other metabolic pathways. Together, our study adds new knowledge to the field of ketone body metabolism and suggests a viable therapeutic strategy involving ketogenesis activation in the prevention and treatment of NAFLD.

Background: The increased incidence of obesity and associated metabolic diseases has driven research focused on genetically or pharmacologically alleviating metabolic dysfunction. These studies employ a range of fasting-refeeding models including 4-24 h fasts, "overnight" fasts, or meal feeding. Still, we lack literature that describes the physiologically relevant adaptations that accompany changes in the duration of fasting and re-feeding. Since the liver is central to whole body metabolic homeostasis, we investigated the timing of the fast-induced shift toward glycogenolysis, gluconeogenesis, and ketogenesis and the meal-induced switch toward glycogenesis and away from ketogenesis. Methods: Twelve to fourteen week old male C57BL/6J mice were fasted for 0, 4, 8, 12, or 16 h and sacrificed 4 h after lights on. In a second study, designed to understand the response to a meal, we gave fasted mice access to feed for 1 or 2 h before sacrifice. We analyzed the data using mixed model analysis of variance. Results: Fasting initiated robust metabolic shifts, evidenced by changes in serum glucose, non-esterified fatty acids (NEFAs), triacylglycerol, and beta-OH butyrate, as well as, liver triacylglycerol, non-esterified fatty acid, and glycogen content. Glycogenolysis is the primary source to maintain serum glucose during the first 8 h of fasting, while de novo gluconeogenesis is the primary source thereafter. The increase in serum a-OH butyrate results from increased enzymatic capacity for fatty acid flux through beta-oxidation and shunting of acetyl-CoA toward ketone body synthesis (increased CPT1 (Carnitine Palmitoyltransferase 1) and HMGCS2 (3-Hydroxy-3-Methylglutaryl-CoA Synthase 2) expression, respectively). In opposition to the relatively slow metabolic adaptation to fasting, feeding of a meal results in rapid metabolic changes including full depression of serum a-OH butyrate and NEFAs within an hour. Conclusions: Herein, we provide a detailed description of timing of the metabolic adaptations in response to fasting and re-feeding to inform study design in experiments of metabolic homeostasis. Since fasting and obesity are both characterized by elevated adipose tissue lipolysis, hepatic lipid accumulation, ketogenesis, and gluconeogenesis, understanding the drivers behind the metabolic shift from the fasted to the fed state may provide targets to limit aberrant gluconeogenesis and ketogenesis in obesity.

Elevated ketone production and utilization results in a host of health benefits. The aim of this study was to assess the rate of ketone production during a prolonged fast and to evaluate how an initial bout of exercise influences this production. Mood and hunger, along with plasma insulin and glucagon, were also assessed. In this crossover study, 20 adult subjects (11 Male, 9 Female) completed two 36-hour fasts, with one protocol requiring the subject to complete an intense treadmill exercise session at the beginning of the fast. Ketone levels were assessed via blood ketone meter and recorded every two hours. Subjective mood and hunger ratings were also recorded every two hours. Venipuncture was performed every 12 hours to assess plasma insulin and glucagon. The mean area under the ketone production curve for the nonexercise intervention was 19.19 ± 2.59 mmol/L and 27.49 ± 2.59 mmol/L for the exercise intervention, resulting in a significant 8.30 mmol/L difference between conditions (95% probability interval was 1.94 to 14.82 mmol/L). The mean time to nutritional ketosis was 21.07 ± 2.95 hours with fasting alone, and 17.5 ± 1.69 hours when combined with exercise (posterior probability = 0.89). There was a significant decrease in insulin over time (F(3,133) = 61.75, p < 0.0001). There was also a significant increase in glucagon over time (F(3,133) = 21.10, p < 0.0001). Hunger and stomach discomfort did not differ between conditions. Anger (F(10,394) = 2.74, p = 0.0028), depression (F(10,394) = 2.91, p = 0.0016), tension (F(10,394) = 2.29, p = 0.0128), vigor (F(10,394) = 11.65, p < 0.0001), and fatigue (F(10,394) = 10.60, p = 0.0001) increased over the course of the fast, but did not differ between conditions. Completing aerobic exercise at the beginning of a 36-hour fast results in significantly more ketone production. The impact of exercise on ketone production comes at little or no impact on hunger, stomach discomfort and negative moods. A difference in time to achieving nutritional ketosis between conditions may exist, but this was not observed in this study.

No description available.

La stéatose hépatique est une affection caractérisée par l'accumulation d'un excès de graisse dans le foie d'un individu sans antécédents d'abus d'alcool. La stéatose hépatique est en train de devenir la maladie chronique du foie la plus répandue dans le monde. En l'absence de thérapies approuvées, les modifications du mode de vie, y compris les interventions diététiques, restent la seule stratégie thérapeutique. Dans cette étude, nous avons cherché à déterminer si un régime riche en graisses (HFD) complété par des triglycérides à chaîne moyenne (TCM) atténue la stéatose hépatique chez les souris. Des souris mâles âgées de 7 semaines C57BL/6 ont été nourries avec un régime riche en graisses puis ont été randomisées pour rester sous régime riche en graisses ou passer à un régime riche en graisses complété par des TCM ou à un régime pauvre en graisses (LFD). Comparées aux souris nourries au HFD, les souris nourries au HFD supplémenté en TCM ont présenté une amélioration significative du degré de stéatose et d'inflammation et une amélioration des tests de tolérance au glucose et à l'insuline avec des changements modestes dans les lipides circulants et les teneurs en triacylglycérol et en cholestérol du foie. Notre étude démontre qu’une diète en gras supplémenté en TCM a des effets bénéfiques sur la stéatose hépatique. Les améliorations observées semblent être liées à la réduction de la teneur hépatique en céramides et en diacylglycérols, améliorant la sensibilité à l’insuline, et faisant des TCM une option non-pharmacologique viable à inclure dans la prise en charge de cette maladie débilitante. / Hepatic steatosis is a condition where excess fat accumulates in an individual's liver without a history of alcohol abuse. Hepatic steatosis is becoming the most common chronic liver disease worldwide. In the absence of approved therapies to specifically treat hepatic steatosis, lifestyle modifications, including dietary interventions, remain the only therapeutic strategy. In this study, we sought to determine whether a high-fat diet (HFD) supplemented with medium-chain triglycerides (MCT) attenuates hepatic steatosis in mice. Seven-week-old C57BL/6 male mice were fed HFD for 12 weeks to induce hepatic steatosis, then mice were randomized to remain on HFD or switch to either HFD supplemented with MCT or low-fat diet (LFD) for 6 weeks. Mice switched to LFD were used as another model of dietary interventions. Compared with mice fed HFD, mice fed HFD supplemented with MCT exhibited significant improvement in the degree of steatosis and inflammation as well as improvement in glucose and insulin tolerance tests with modest changes in circulating lipids and liver triacylglycerol and cholesterol contents, the hallmark of hepatic steatosis. Our study demonstrates that HFD supplement with MCT has beneficial effects on hepatic steatosis. The observed improvements seem to be linked to reductions in hepatic ceramide and diacylglycerol content, which ultimately prevents protein kinase C-ε translocation to the plasma membrane and improves insulin sensitivity, making a dietary supplement like MCTs, a viable non-pharmacological option in the management of this debilitating disease.

La plupart des conditions détectées par le dépistage néonatal sont reliées à l'une des enzymes qui dégradent les acyls-CoA mitochondriaux. Le rôle physiopathologique des acyls-CoA dans ces maladies est peu connue, en partie parce que les esters liés au CoA sont intracellulaires et les échantillons tissulaires de patients humains ne sont généralement pas disponibles. Nous avons créé une modèle animal murin de l'une de ces maladies, la déficience en 3-hydroxy-3-methylglutaryl-CoA lyase (HL), dans le foie (souris HLLKO). HL est la dernière enzyme de la cétogenèse et de la dégradation de la leucine. Une déficience chronique en HL et les crises métaboliques aigües, produisent chacune un portrait anormal et distinct d'acyls-CoA hépatiques. Ces profils ne sont pas prévisibles à partir des niveaux d'acides organiques urinaires et d'acylcarnitines plasmatiques. La cétogenèse est indétectable dans les hépatocytes HLLKO. Dans les mitochondries HLLKO isolées, le dégagement de 14CO2 à partir du [2-14C]pyruvate a diminué en présence de 2-ketoisocaproate (KIC), un métabolite de la leucine. Au test de tolérance au pyruvate, une mesure de la gluconéogenèse, les souris HLLKO ne présentent pas la réponse hyperglycémique normale. L'hyperammoniémie et l'hypoglycémie, des signes classiques de plusieurs erreurs innées du métabolisme (EIM) des acyls-CoA, surviennent de façon spontanée chez des souris HLLKO et sont inductibles par l'administration de KIC. Une charge en KIC augmente le niveau d'acyls-CoA reliés à la leucine et diminue le niveau d'acétyl-CoA. Les mitochondries des hépatocytes des souris HLLKO traitées avec KIC présentent un gonflement marqué. L'hyperammoniémie des souris HLLKO répond au traitement par l'acide N-carbamyl-L-glutamique. Ce composé permet de contourner une enzyme acétyl-CoA-dépendante essentielle pour l’uréogenèse, le N-acétylglutamate synthase. Ceci démontre un mécanisme d’hyperammoniémie lié aux acyls-CoA. Dans une deuxième EIM des acyls-CoA, la souris SCADD, déficiente en déshydrogénase des acyls-CoA à chaînes courtes. Le profil des acyls-CoA hépatiques montre un niveau élevé du butyryl-CoA particulièrement après un jeûne et après une charge en triglycérides à chaîne moyenne précurseurs du butyryl-CoA. / Most conditions detected by expanded newborn screening result from deficiency of one of the enzymes that degrade acyl-CoA esters in mitochondria. The role of acyl-CoAs in the pathophysiology of these disorders is poorly understood, in part because CoA esters are intracellular and samples are not generally available from human patients. We created a mouse model of one such condition, deficiency of 3-hydroxy-3-methylglutaryl-CoA lyase (HL), in liver (HLLKO mice). HL catalyses a reaction of ketone body synthesis and of leucine degradation. Chronic HL deficiency and acute crises each produced distinct abnormal liver acyl-CoA patterns, which would not be predictable from levels of urine organic acids and plasma acylcarnitines. In HLLKO hepatocytes, ketogenesis was undetectable. Measures of Krebs cycle flux diminished following incubation of HLLKO mitochondria with the leucine metabolite 2-ketoisocaproate (KIC). HLLKO mice also had suppression of the normal hyperglycemic response to a systemic pyruvate load, a measure of gluconeogenesis. Hyperammonemia and hypoglycemia, cardinal features of many inborn errors of acyl-CoA metabolism, occurred spontaneously in some HLLKO mice and were inducible by administering KIC. KIC loading also increased levels of several leucine-related acyl-CoAs and reduced acetyl-CoA levels. Ultrastructurally, hepatocyte mitochondria of KIC-treated HLLKO mice show marked swelling. KIC-induced hyperammonemia improved following administration of carglumate (N-carbamyl-L-glutamic acid), which bypasses an acetyl-CoA-dependent reaction essential for urea cycle function, thus demonstrating an acyl-CoA-related mechanism for this complication. In a second animal model of an inborn error of acyl-CoA metabolism, short chain acyl-CoA dehydrogenase (SCAD)-deficient mice, the main finding in liver acyl-CoAs is increased butyryl-CoA, particularly during fasting or after enteral loading with medium chain triglyceride precursor of butyryl-CoA.

La plupart des conditions détectées par le dépistage néonatal sont reliées à l'une des enzymes qui dégradent les acyls-CoA mitochondriaux. Le rôle physiopathologique des acyls-CoA dans ces maladies est peu connue, en partie parce que les esters liés au CoA sont intracellulaires et les échantillons tissulaires de patients humains ne sont généralement pas disponibles. Nous avons créé une modèle animal murin de l'une de ces maladies, la déficience en 3-hydroxy-3-methylglutaryl-CoA lyase (HL), dans le foie (souris HLLKO). HL est la dernière enzyme de la cétogenèse et de la dégradation de la leucine. Une déficience chronique en HL et les crises métaboliques aigües, produisent chacune un portrait anormal et distinct d'acyls-CoA hépatiques. Ces profils ne sont pas prévisibles à partir des niveaux d'acides organiques urinaires et d'acylcarnitines plasmatiques. La cétogenèse est indétectable dans les hépatocytes HLLKO. Dans les mitochondries HLLKO isolées, le dégagement de 14CO2 à partir du [2-14C]pyruvate a diminué en présence de 2-ketoisocaproate (KIC), un métabolite de la leucine. Au test de tolérance au pyruvate, une mesure de la gluconéogenèse, les souris HLLKO ne présentent pas la réponse hyperglycémique normale. L'hyperammoniémie et l'hypoglycémie, des signes classiques de plusieurs erreurs innées du métabolisme (EIM) des acyls-CoA, surviennent de façon spontanée chez des souris HLLKO et sont inductibles par l'administration de KIC. Une charge en KIC augmente le niveau d'acyls-CoA reliés à la leucine et diminue le niveau d'acétyl-CoA. Les mitochondries des hépatocytes des souris HLLKO traitées avec KIC présentent un gonflement marqué. L'hyperammoniémie des souris HLLKO répond au traitement par l'acide N-carbamyl-L-glutamique. Ce composé permet de contourner une enzyme acétyl-CoA-dépendante essentielle pour l’uréogenèse, le N-acétylglutamate synthase. Ceci démontre un mécanisme d’hyperammoniémie lié aux acyls-CoA. Dans une deuxième EIM des acyls-CoA, la souris SCADD, déficiente en déshydrogénase des acyls-CoA à chaînes courtes. Le profil des acyls-CoA hépatiques montre un niveau élevé du butyryl-CoA particulièrement après un jeûne et après une charge en triglycérides à chaîne moyenne précurseurs du butyryl-CoA. / Most conditions detected by expanded newborn screening result from deficiency of one of the enzymes that degrade acyl-CoA esters in mitochondria. The role of acyl-CoAs in the pathophysiology of these disorders is poorly understood, in part because CoA esters are intracellular and samples are not generally available from human patients. We created a mouse model of one such condition, deficiency of 3-hydroxy-3-methylglutaryl-CoA lyase (HL), in liver (HLLKO mice). HL catalyses a reaction of ketone body synthesis and of leucine degradation. Chronic HL deficiency and acute crises each produced distinct abnormal liver acyl-CoA patterns, which would not be predictable from levels of urine organic acids and plasma acylcarnitines. In HLLKO hepatocytes, ketogenesis was undetectable. Measures of Krebs cycle flux diminished following incubation of HLLKO mitochondria with the leucine metabolite 2-ketoisocaproate (KIC). HLLKO mice also had suppression of the normal hyperglycemic response to a systemic pyruvate load, a measure of gluconeogenesis. Hyperammonemia and hypoglycemia, cardinal features of many inborn errors of acyl-CoA metabolism, occurred spontaneously in some HLLKO mice and were inducible by administering KIC. KIC loading also increased levels of several leucine-related acyl-CoAs and reduced acetyl-CoA levels. Ultrastructurally, hepatocyte mitochondria of KIC-treated HLLKO mice show marked swelling. KIC-induced hyperammonemia improved following administration of carglumate (N-carbamyl-L-glutamic acid), which bypasses an acetyl-CoA-dependent reaction essential for urea cycle function, thus demonstrating an acyl-CoA-related mechanism for this complication. In a second animal model of an inborn error of acyl-CoA metabolism, short chain acyl-CoA dehydrogenase (SCAD)-deficient mice, the main finding in liver acyl-CoAs is increased butyryl-CoA, particularly during fasting or after enteral loading with medium chain triglyceride precursor of butyryl-CoA.