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Comparative efficacy of THR-β agonists, FGF-21 analogues, GLP-1R agonists, GLP-1-based polyagonists, and Pan-PPAR agonists for MASLD: A systematic review and network meta-analysis THR-β 激动剂、FGF-21 类似物、GLP-1R 激动剂、基于 GLP-1 的多拮抗剂和 Pan-PPAR 激动剂治疗 MASLD 的疗效比较:系统综述和网络荟萃分析。
IF 10.8 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-30 DOI: 10.1016/j.metabol.2024.156043
Ru-Tao Lin , Qin-Mei Sun , Xin Xin , Cheng Han Ng , Luca Valenti , Yi-Yang Hu , Ming-Hua Zheng , Qin Feng

Aims

To compare the efficacy of thyroid hormone receptor beta (THR-β) agonists, fibroblast growth factor 21 (FGF-21) analogues, glucagon-like peptide-1 receptor agonists (GLP-1RAs), GLP-1-based polyagonists, and pan-peroxisome proliferator-activated receptor (Pan-PPAR) agonists in the treatment of metabolic dysfunction-associated steatotic liver disease (MASLD).

Methods

A database search for relevant randomized double-blind controlled trials published until July 11, 2024, was conducted. Primary outcomes were the relative change in hepatic fat fraction (HFF) and liver stiffness assessed non-invasively by magnetic resonance imaging proton density fat fraction and elastography. Secondary outcomes included histology, liver injury index, lipid profile, glucose metabolism, blood pressure, and body weight.

Results

Twenty-seven trials (5357 patients with MASLD) were identified. For HFF reduction, GLP-1-based polyagonists were most potentially effective (mean difference [MD] −51.47; 95 % confidence interval [CI]: −68.25 to −34.68; surface under the cumulative ranking curve [SUCRA] 84.9) vs. placebo, followed by FGF-21 analogues (MD −47.08; 95 % CI: −58.83 to −35.34; SUCRA 75.5), GLP-1R agonists (MD −37.36; 95 % CI: −69.52 to −5.21; SUCRA 52.3) and THR-β agonists (MD −33.20; 95 % CI: −43.90 to −22.51; SUCRA 36.9). For liver stiffness, FGF-21 analogues were most potentially effective (MD −9.65; 95 % CI: −19.28 to −0.01; SUCRA 82.2) vs. placebo, followed by THR-β agonists (MD −5.79; 95 % CI: −9.50 to −2.09; SUCRA 58.2), and GLP-1RAs (MD −5.58; 95 % CI: −15.02 to 3.86; SUCRA 54.7). For fibrosis improvement in histology, GLP-1-based polyagonists were most potentially effective, followed by FGF-21 analogues, THR-β agonists, Pan-PPAR agonists, and GLP-1R agonists; For MASH resolution in histology, GLP-1-based polyagonists were most potentially effective, followed by THR-β agonists, GLP-1R agonists, FGF-21 analogues, and Pan-PPAR agonists. THR-β agonists are well-balanced in liver steatosis and fibrosis, and excel at improving lipid profiles; FGF-21 analogues are effective at improving steatosis and particularly exhibit strong antifibrotic abilities. GLP-1R agonists showed significant benefits in improving liver steatosis, glucose metabolism, and body weight. GLP-1-based polyagonists have demonstrated the most potential efficacy overall in terms of comprehensive curative effect. Pan-PPAR agonists showed distinct advantages in improving liver function and glucose metabolism.

Conclusion

These results illustrate the relative superiority of the five classes of therapy in the treatment of MASLD and may serve as guidance for the development of combination therapies.
目的:比较甲状腺激素受体β(THR-β)激动剂、成纤维细胞生长因子21(FGF-21)类似物、胰高血糖素样肽-1受体激动剂(GLP-1RA)、基于GLP-1的多拮抗剂和泛过氧化物酶体增殖激活受体(Pan-PPAR)激动剂治疗代谢功能障碍相关性脂肪性肝病(MASLD)的疗效:方法:对截至2024年7月11日发表的相关随机双盲对照试验进行数据库检索。主要结果是肝脏脂肪分数(HFF)和肝脏硬度的相对变化,通过磁共振成像质子密度脂肪分数和弹性成像进行无创评估。次要结果包括组织学、肝损伤指数、血脂概况、糖代谢、血压和体重:结果:确定了 27 项试验(5357 名 MASLD 患者)。在降低 HFF 方面,GLP-1 多效拮抗剂与安慰剂相比最有潜在疗效(平均差 [MD] -51.47;95% 置信区间 [CI]:-68.25 至 -34.68;累积排名曲线下表面 [SUCRA] 84.9),其次是 FGF 多效拮抗剂。其次是 FGF-21 类似物(MD -47.08;95 % CI:-58.83 至 -35.34;SUCRA 75.5)、GLP-1R 激动剂(MD -37.36;95 % CI:-69.52 至 -5.21;SUCRA 52.3)和 THR-β 激动剂(MD -33.20;95 % CI:-43.90 至 -22.51;SUCRA 36.9)。与安慰剂相比,FGF-21 类似物对肝僵化的潜在疗效最高(MD -9.65;95 % CI:-19.28 至 -0.01;SUCRA 82.2),其次是 THR-β 激动剂(MD -5.79;95 % CI:-9.50 至 -2.09;SUCRA 58.2)和 GLP-1RAs (MD -5.58;95 % CI:-15.02 至 3.86;SUCRA 54.7)。对于组织学上的纤维化改善,GLP-1 多拮抗剂的潜在疗效最好,其次是 FGF-21 类似物、THR-β 激动剂、Pan-PPAR 激动剂和 GLP-1R 激动剂;对于组织学上的 MASH 缓解,GLP-1 多拮抗剂的潜在疗效最好,其次是 THR-β 激动剂、GLP-1R 激动剂、FGF-21 类似物和 Pan-PPAR 激动剂。THR-β 激动剂在治疗肝脏脂肪变性和纤维化方面效果均衡,擅长改善血脂状况;FGF-21 类似物可有效改善脂肪变性,尤其具有很强的抗纤维化能力。GLP-1R 激动剂在改善肝脏脂肪变性、糖代谢和体重方面有显著疗效。就综合疗效而言,GLP-1 多拮抗剂显示出了最潜在的疗效。泛 PPAR 激动剂在改善肝功能和糖代谢方面具有明显优势:这些结果说明了五类疗法在治疗 MASLD 方面的相对优越性,可为开发联合疗法提供指导。
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引用次数: 0
PDCD4 deficiency in hepatocytes exacerbates nonalcoholic steatohepatitis through enhanced MHC class II transactivator expression 肝细胞中 PDCD4 的缺乏会通过增强 MHC II 类转录因子的表达而加剧非酒精性脂肪性肝炎。
IF 10.8 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-27 DOI: 10.1016/j.metabol.2024.156036
Kaikai Lu , Lei He , Zizhen Guo , Mengda Li , Xiaona Cheng , Sitong Liu , Tianyun Zhang , Qian Chen , Rong Zhao , Luyun Yang , Xiaodan Wu , Kexin Cheng , Peihai Cao , Litao Wu , Muhammad Shahzad , Minghua Zheng , Lianying Jiao , Yue Wu , Dongmin Li
Nonalcoholic steatohepatitis (NASH) is a primary cause of liver cirrhosis and hepatocellular carcinoma, presenting a significant and unmet medical challenge. The necessity to investigate the molecular mechanisms underlying NASH is highlighted by the observed decrease in programmed cell death 4 (PDCD4) expression in NASH patients, suggesting that PDCD4 may play a protective role in maintaining liver health. In this study, we identify PDCD4 as a natural inhibitor of NASH development in mice. The absence of PDCD4 leads to the spontaneous progression of NASH. Notably, PDCD4-deficient hepatocytes display elevated major histocompatibility complex class II (MHCII) expression due to CIITA activation, indicating that PCDC4 prevents the abnormal transformation of hepatocytes into antigen-presenting cells (APCs). Cell co-culture experiments reveal that hepatocytes lacking PDCD4, which resemble APCs, can directly activate CD4+ T cells by presenting multiple peptides, resulting in the release of inflammatory factors. Additionally, both cellular and animal studies show that CIITA promotes lipid accumulation in hepatocytes and exacerbates NASH progression. In summary, our findings reveal a novel role of PDCD4 in regulating CIITA and MHCII expression during NASH development, offering new therapeutic approaches for NASH treatment.
非酒精性脂肪性肝炎(NASH)是导致肝硬化和肝细胞癌的主要原因,是一项尚未解决的重大医学挑战。在非酒精性脂肪性肝炎患者中观察到的程序性细胞死亡 4(PDCD4)表达减少,表明 PDCD4 可能在维持肝脏健康方面发挥保护作用,这凸显了研究非酒精性脂肪性肝炎分子机制的必要性。在这项研究中,我们发现 PDCD4 是小鼠发生 NASH 的天然抑制剂。PDCD4 的缺失会导致 NASH 的自发发展。值得注意的是,由于 CIITA 的激活,PDCD4 缺失的肝细胞显示出主要组织相容性复合体 II 类(MHCII)表达的升高,这表明 PCDC4 阻止了肝细胞向抗原递呈细胞(APC)的异常转化。细胞共培养实验显示,缺乏 PDCD4 的肝细胞与 APC 相似,可通过呈递多种肽直接激活 CD4+ T 细胞,导致炎症因子的释放。此外,细胞和动物研究都表明,CIITA 会促进肝细胞中的脂质积累,并加剧 NASH 的进展。总之,我们的研究结果揭示了 PDCD4 在 NASH 发展过程中调控 CIITA 和 MHCII 表达的新作用,为治疗 NASH 提供了新的治疗方法。
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引用次数: 0
Membrane tension sensing formin-binding protein 1 is a neuronal nutrient stress-responsive Golgiphagy receptor. 膜张力传感甲形蛋白结合蛋白1是一种神经元营养应激反应性Golgiphagy受体。
IF 10.8 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-26 DOI: 10.1016/j.metabol.2024.156040
Smita Saha, Anirban Mandal, Akash Ranjan, Debasish Kumar Ghosh

Background: Nutrient stress-responsive neuronal homeostasis relies on intricate autophagic mechanisms that modulate various organelle integrity and function. The selective autophagy of the Golgi, known as Golgiphagy, regulates secretory processes by modulating vesicle trafficking during nutrient starvation.

Results: In this study, we explored a genetic screen of BAR-domain-containing proteins to elucidate the role of formin-binding protein 1 (FNBP1) as a Golgiphagy receptor in modulating Golgi dynamics in response to varying nutrient availability in neurons. Mapping the systems network of FNBP1 and its interacting proteins reveals the putative involvement of FNBP1 in autophagy and Golgi-associated processes. While nutrient depletion causes Golgi fragmentation, FNBP1 preferentially localizes to the fragmented Golgi membrane through its 284FEDYTQ289 motif during nutrient stress. Simultaneously, FNBP1 engages in molecular interactions with LC3B through a conserved 131WKQL134 LC3 interacting region, thereby sequestering the fragmented Golgi membrane in neuronal autophagosomes. Increased aggregation of GM130, abnormal clumping of RAB11-positive secretory granules, and enhanced senescent death of FNBP1-depleted starved neurons indicate disruptions of neuronal homeostasis under metabolic stress.

Conclusion: The identification of FNBP1 as a nutrient stress-responsive Golgiphagy receptor expands our insights into the molecular mechanisms underlying Golgiphagy, establishing the crosstalk between nutrient sensing and membrane tension-sensing regulatory autophagic processes of Golgi turnover in neurons.

背景:营养应激反应性神经元稳态依赖于复杂的自噬机制,这些机制调节各种细胞器的完整性和功能。高尔基体的选择性自噬被称为 "高尔基自噬"(Golgiphagy),它在营养饥饿期间通过调节囊泡贩运来调节分泌过程:在这项研究中,我们对含BAR域的蛋白进行了基因筛选,以阐明甲形蛋白结合蛋白1(FNBP1)作为高尔基自噬受体在调节神经元高尔基体动态以应对不同营养物质可用性方面的作用。绘制 FNBP1 及其互作蛋白的系统网络图揭示了 FNBP1 可能参与自噬和高尔基相关过程。当营养物质耗竭导致高尔基体破碎时,FNBP1会在营养物质压力下通过其284FEDYTQ289基序优先定位到破碎的高尔基体膜上。同时,FNBP1 通过保守的 131WKQL134 LC3 相互作用区域与 LC3B 进行分子相互作用,从而将破碎的高尔基体膜封闭在神经元自噬体中。FNBP1缺失的饥饿神经元的GM130聚集增加、RAB11阳性分泌颗粒异常结块以及衰老死亡增强表明,在代谢压力下神经元的平衡被破坏:结论:FNBP1是一种营养应激反应性高尔基吞噬受体,它的发现拓展了我们对高尔基吞噬分子机制的认识,建立了神经元高尔基周转的营养传感和膜张力传感调控自噬过程之间的相互联系。
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引用次数: 0
Protein kinase N1 deficiency results in upregulation of cerebral energy metabolism and is highly protective in in vivo and in vitro stroke models 蛋白激酶 N1 缺乏会导致脑能量代谢上调,并在体内和体外中风模型中具有高度保护作用。
IF 10.8 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-26 DOI: 10.1016/j.metabol.2024.156039
Stephanie zur Nedden , Motahareh S. Safari , Dido Weber , Louisa Kuenkel , Carolin Garmsiri , Luisa Lang , Cyrille Orset , Tom Freret , Benoît Haelewyn , Madlen Hotze , Marcel Kwiatkowski , Bettina Sarg , Klaus Faserl , Dragana Savic , Ira-Ida Skvortsova , Anne Krogsdam , Sandro Carollo , Zlatko Trajanoski , Herbert Oberacher , Dominik Zlotek , Gabriele Baier-Bitterlich
<div><h3>Background and aim</h3><div>We recently identified protein kinase N1 (PKN1) as a master regulator of brain development. However, its function in the adult brain has not been clearly established. In this study, we assessed the cerebral energetic phenotype of wildtype (WT) and global <em>Pkn1</em> knockout (<em>Pkn1</em><sup><em>−/−</em></sup>) animals under physiological and pathophysiological conditions.</div></div><div><h3>Methods</h3><div>Cerebral energy metabolism was analyzed by <sup>13</sup>C<sub>6</sub>-glucose tracing <em>in vivo</em> and real time seahorse analysis of extracellular acidification rates as well as mitochondrial oxygen consumption rates (OCR) of brain slice punches <em>in vitro</em>. Isolated WT and <em>Pkn1</em><sup><em>−/−</em></sup> brain mitochondria were tested for differences in OCR with different substrates. Metabolite levels were determined by mass spectrometric analysis in brain slices under control and energetic stress conditions, induced by oxygen-glucose deprivation and reperfusion, an <em>in vitro</em> model of ischemic stroke. Differences in enzyme activities were assessed by enzymatic assays, western blotting and bulk RNA sequencing. A middle cerebral artery occlusion stroke model was used to analyze lesion volumes and functional recovery in WT and <em>Pkn1</em><sup><em>−/−</em></sup> mice.</div></div><div><h3>Results</h3><div><em>Pkn1</em> deficiency resulted in a remarkable upregulation of cerebral energy metabolism, <em>in vivo</em> and <em>in vitro</em>. This was due to two separate mechanisms involving an enhanced glycolytic flux and higher pyruvate-induced mitochondrial OCR. Mechanistically we show that <em>Pkn1</em><sup>−/−</sup> brain tissue exhibits an increased activity of the glycolysis rate-limiting enzyme phosphofructokinase. Additionally, glucose-1,6-bisphosphate levels, a metabolite that increases mitochondrial pyruvate uptake, were elevated upon <em>Pkn1</em> deficiency. Consequently, <em>Pkn1</em><sup><em>−/−</em></sup> brain slices had more ATP and a greater accumulation of ATP degradation metabolites during energetic stress. This translated into increased phosphorylation and activity of adenosine monophosphate (AMP)-activated protein kinase (AMPK) during <em>in vitro</em> stroke. Accordingly, <em>Pkn1</em><sup><em>−/−</em></sup> brain slices showed a post-ischemic transcriptional upregulation of energy metabolism pathways and <em>Pkn1</em> deficiency was strongly protective in <em>in vitro</em> and <em>in vivo</em> stroke models. While inhibition of mitochondrial pyruvate uptake only moderately affected the protective phenotype, inhibition of AMPK in <em>Pkn1</em><sup><em>−/−</em></sup> slices increased post-ischemic cell death <em>in vitro</em>.</div></div><div><h3>Conclusion</h3><div>This is the first study to comprehensively demonstrate an essential and unique role of PKN1 in cerebral energy metabolism, regulating glycolysis and mitochondrial pyruvate-induced respiration. We furt
背景和目的:我们最近发现蛋白激酶 N1(PKN1)是大脑发育的主要调节因子。然而,它在成人大脑中的功能尚未明确确定。在这项研究中,我们评估了野生型(WT)和全基因Pkn1敲除(Pkn1-/-)动物在生理和病理生理条件下的脑能量表型:方法:通过体内13C6-葡萄糖追踪和体外实时海马分析细胞外酸化率以及脑切片冲片线粒体耗氧率(OCR)来分析脑能量代谢。对分离的 WT 和 Pkn1-/- 脑线粒体进行了测试,以确定不同底物在 OCR 方面的差异。在缺血性中风的体外模型中,通过氧-葡萄糖剥夺和再灌注诱导的控制和能量应激条件下,通过质谱分析测定脑片中的代谢物水平。酶测定、Western 印迹和大量 RNA 测序评估了酶活性的差异。使用大脑中动脉闭塞中风模型分析 WT 小鼠和 Pkn1-/- 小鼠的病变体积和功能恢复情况:结果:Pkn1 缺乏导致体内和体外大脑能量代谢显著上调。这是由于两种不同的机制造成的,其中包括糖酵解通量的增强和丙酮酸诱导的线粒体 OCR 的增加。从机理上讲,我们发现 Pkn1-/- 脑组织的糖酵解限速酶磷酸果激酶的活性增加。此外,Pkn1 缺乏时,1,6-二磷酸葡萄糖(一种可增加线粒体丙酮酸摄取的代谢产物)水平升高。因此,在能量应激期间,Pkn1-/-脑片有更多的 ATP 和更多的 ATP 降解代谢物积累。这转化为体外中风期间单磷酸腺苷(AMP)激活的蛋白激酶(AMPK)的磷酸化和活性增加。因此,Pkn1-/-脑片显示出缺血后能量代谢途径的转录上调,Pkn1的缺乏在体外和体内中风模型中具有很强的保护作用。虽然抑制线粒体丙酮酸摄取对保护性表型影响不大,但抑制Pkn1-/-脑片中的AMPK会增加体外缺血后的细胞死亡:这是首次全面证明 PKN1 在脑能量代谢中的重要和独特作用的研究,它同时调节糖酵解和线粒体丙酮酸诱导的呼吸。我们还进一步发现了在体外和体内中风模型中缺乏 Pkn1 的高度保护性表型,从而验证了抑制 PKN1 是开发新型中风疗法的一个很有前景的新治疗靶点。
{"title":"Protein kinase N1 deficiency results in upregulation of cerebral energy metabolism and is highly protective in in vivo and in vitro stroke models","authors":"Stephanie zur Nedden ,&nbsp;Motahareh S. Safari ,&nbsp;Dido Weber ,&nbsp;Louisa Kuenkel ,&nbsp;Carolin Garmsiri ,&nbsp;Luisa Lang ,&nbsp;Cyrille Orset ,&nbsp;Tom Freret ,&nbsp;Benoît Haelewyn ,&nbsp;Madlen Hotze ,&nbsp;Marcel Kwiatkowski ,&nbsp;Bettina Sarg ,&nbsp;Klaus Faserl ,&nbsp;Dragana Savic ,&nbsp;Ira-Ida Skvortsova ,&nbsp;Anne Krogsdam ,&nbsp;Sandro Carollo ,&nbsp;Zlatko Trajanoski ,&nbsp;Herbert Oberacher ,&nbsp;Dominik Zlotek ,&nbsp;Gabriele Baier-Bitterlich","doi":"10.1016/j.metabol.2024.156039","DOIUrl":"10.1016/j.metabol.2024.156039","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background and aim&lt;/h3&gt;&lt;div&gt;We recently identified protein kinase N1 (PKN1) as a master regulator of brain development. However, its function in the adult brain has not been clearly established. In this study, we assessed the cerebral energetic phenotype of wildtype (WT) and global &lt;em&gt;Pkn1&lt;/em&gt; knockout (&lt;em&gt;Pkn1&lt;/em&gt;&lt;sup&gt;&lt;em&gt;−/−&lt;/em&gt;&lt;/sup&gt;) animals under physiological and pathophysiological conditions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Cerebral energy metabolism was analyzed by &lt;sup&gt;13&lt;/sup&gt;C&lt;sub&gt;6&lt;/sub&gt;-glucose tracing &lt;em&gt;in vivo&lt;/em&gt; and real time seahorse analysis of extracellular acidification rates as well as mitochondrial oxygen consumption rates (OCR) of brain slice punches &lt;em&gt;in vitro&lt;/em&gt;. Isolated WT and &lt;em&gt;Pkn1&lt;/em&gt;&lt;sup&gt;&lt;em&gt;−/−&lt;/em&gt;&lt;/sup&gt; brain mitochondria were tested for differences in OCR with different substrates. Metabolite levels were determined by mass spectrometric analysis in brain slices under control and energetic stress conditions, induced by oxygen-glucose deprivation and reperfusion, an &lt;em&gt;in vitro&lt;/em&gt; model of ischemic stroke. Differences in enzyme activities were assessed by enzymatic assays, western blotting and bulk RNA sequencing. A middle cerebral artery occlusion stroke model was used to analyze lesion volumes and functional recovery in WT and &lt;em&gt;Pkn1&lt;/em&gt;&lt;sup&gt;&lt;em&gt;−/−&lt;/em&gt;&lt;/sup&gt; mice.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;&lt;em&gt;Pkn1&lt;/em&gt; deficiency resulted in a remarkable upregulation of cerebral energy metabolism, &lt;em&gt;in vivo&lt;/em&gt; and &lt;em&gt;in vitro&lt;/em&gt;. This was due to two separate mechanisms involving an enhanced glycolytic flux and higher pyruvate-induced mitochondrial OCR. Mechanistically we show that &lt;em&gt;Pkn1&lt;/em&gt;&lt;sup&gt;−/−&lt;/sup&gt; brain tissue exhibits an increased activity of the glycolysis rate-limiting enzyme phosphofructokinase. Additionally, glucose-1,6-bisphosphate levels, a metabolite that increases mitochondrial pyruvate uptake, were elevated upon &lt;em&gt;Pkn1&lt;/em&gt; deficiency. Consequently, &lt;em&gt;Pkn1&lt;/em&gt;&lt;sup&gt;&lt;em&gt;−/−&lt;/em&gt;&lt;/sup&gt; brain slices had more ATP and a greater accumulation of ATP degradation metabolites during energetic stress. This translated into increased phosphorylation and activity of adenosine monophosphate (AMP)-activated protein kinase (AMPK) during &lt;em&gt;in vitro&lt;/em&gt; stroke. Accordingly, &lt;em&gt;Pkn1&lt;/em&gt;&lt;sup&gt;&lt;em&gt;−/−&lt;/em&gt;&lt;/sup&gt; brain slices showed a post-ischemic transcriptional upregulation of energy metabolism pathways and &lt;em&gt;Pkn1&lt;/em&gt; deficiency was strongly protective in &lt;em&gt;in vitro&lt;/em&gt; and &lt;em&gt;in vivo&lt;/em&gt; stroke models. While inhibition of mitochondrial pyruvate uptake only moderately affected the protective phenotype, inhibition of AMPK in &lt;em&gt;Pkn1&lt;/em&gt;&lt;sup&gt;&lt;em&gt;−/−&lt;/em&gt;&lt;/sup&gt; slices increased post-ischemic cell death &lt;em&gt;in vitro&lt;/em&gt;.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;This is the first study to comprehensively demonstrate an essential and unique role of PKN1 in cerebral energy metabolism, regulating glycolysis and mitochondrial pyruvate-induced respiration. We furt","PeriodicalId":18694,"journal":{"name":"Metabolism: clinical and experimental","volume":"161 ","pages":"Article 156039"},"PeriodicalIF":10.8,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142350223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Starvation and infection: The role of sickness-associated anorexia in metabolic adaptation during acute infection 饥饿与感染:疾病引起的厌食在急性感染期间的代谢适应中的作用。
IF 10.8 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-24 DOI: 10.1016/j.metabol.2024.156035
Jessy Jindal , Jennifer Hill , Jodie Harte , Susanna J. Dunachie , Barbara Kronsteiner
Sickness-associated anorexia, the reduction in appetite seen during infection, is a widely conserved and well-recognized symptom of acute infection, yet there is very little understanding of its functional role in recovery. Anorexic sickness behaviours can be understood as an evolutionary strategy to increase tolerance to pathogen-mediated illness. In this review we explore the evidence for mechanisms and potential metabolic benefits of sickness-associated anorexia. Energy intake can impact on the immune response, control of inflammation and tissue stress, and on pathogen fitness. Fasting mediators including hormone-sensitive lipase, peroxisome proliferator-activated receptor-alpha (PPAR-α) and ketone bodies are potential facilitators of infection recovery through multiple pathways including suppression of inflammation, adaptation to lipid utilising pathways, and resistance to pathogen-induced cellular stress. However, the effect and benefit of calorie restriction is highly heterogeneous depending on both the infection and the metabolic status of the host, which has implications regarding clinical recommendations for feeding during different infections.
病态相关性厌食,即感染期间出现的食欲下降,是急性感染的一种广泛存在和公认的症状,但人们对其在恢复过程中的功能性作用却知之甚少。厌食疾病行为可被理解为一种进化策略,旨在提高对病原体介导的疾病的耐受性。在这篇综述中,我们将探讨疾病相关厌食症的机制和潜在代谢益处的证据。能量摄入会影响免疫反应、炎症和组织应激的控制以及病原体的适应性。包括激素敏感脂肪酶、过氧化物酶体增殖激活受体-α(PPAR-α)和酮体在内的空腹介质可通过多种途径促进感染恢复,包括抑制炎症、适应脂质利用途径和抵抗病原体诱导的细胞应激。然而,热量限制的效果和益处因感染和宿主的新陈代谢状况不同而存在很大差异,这对不同感染期间的临床喂养建议产生了影响。
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引用次数: 0
Disruption of branched-chain amino acid homeostasis promotes the progression of DKD via enhancing inflammation and fibrosis-associated epithelial-mesenchymal transition. 支链氨基酸平衡的破坏通过增强炎症和纤维化相关的上皮-间质转化促进了 DKD 的进展。
IF 10.8 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-22 DOI: 10.1016/j.metabol.2024.156037
Xiaoqing Deng, Chao Tang, Ting Fang, Ting Li, Xiaoyu Li, Yajin Liu, Xuejiao Zhang, Bei Sun, Haipeng Sun, Liming Chen

Background and aims: The disrupted homeostasis of branched-chain amino acids (BCAAs, including leucine, isoleucine, and valine) has been strongly correlated with diabetes with a potential causal role. However, the relationship between BCAAs and diabetic kidney disease (DKD) remains to be established. Here, we show that the elevated BCAAs from BCAAs homeostatic disruption promote DKD progression unexpectedly as an independent risk factor.

Methods and results: Similar to other tissues, the suppressed BCAAs catabolic gene expression and elevated BCAAs abundance were detected in the kidneys of type 2 diabetic mice and individuals with DKD. Genetic and nutritional studies demonstrated that the elevated BCAAs from systemic disruption of BCAAs homeostasis promoted the progression of DKD. Of note, the elevated BCAAs promoted DKD progression without exacerbating diabetes in the animal models of type 2 DKD. Mechanistic studies demonstrated that the elevated BCAAs promoted fibrosis-associated epithelial-mesenchymal transition (EMT) by enhancing the activation of proinflammatory macrophages through mTOR signaling. Furthermore, pharmacological enhancement of systemic BCAAs catabolism using small molecule inhibitor attenuated type 2 DKD. Finally, the elevated BCAAs also promoted DKD progression in type 1 diabetic mice without exacerbating diabetes.

Conclusion: BCAA homeostatic disruption serves as an independent risk factor for DKD and restoring BCAA homeostasis pharmacologically or dietarily represents a promising therapeutic strategy to ameliorate the progression of DKD.

背景和目的:支链氨基酸(BCAAs,包括亮氨酸、异亮氨酸和缬氨酸)平衡紊乱与糖尿病密切相关,可能是糖尿病的诱因。然而,支链氨基酸与糖尿病肾病(DKD)之间的关系仍有待确定。在这里,我们发现 BCAAs 同工酶紊乱导致的 BCAAs 升高作为一个独立的风险因素意外地促进了 DKD 的进展:与其他组织相似,在 2 型糖尿病小鼠和 DKD 患者的肾脏中检测到 BCAAs 分解基因表达受抑制和 BCAAs 丰度升高。遗传学和营养学研究表明,全身性 BCAAs 平衡紊乱导致的 BCAAs 升高促进了 DKD 的进展。值得注意的是,在 2 型 DKD 动物模型中,升高的 BCAAs 在促进 DKD 进展的同时并不会加重糖尿病。机理研究表明,升高的 BCAAs 可通过 mTOR 信号增强促炎巨噬细胞的活化,从而促进纤维化相关的上皮-间质转化(EMT)。此外,使用小分子抑制剂通过药物增强全身性 BCAAs 分解代谢可减轻 2 型 DKD。最后,升高的 BCAAs 也会促进 1 型糖尿病小鼠的 DKD 进展,但不会加重糖尿病:结论:BCAA平衡失调是导致DKD的一个独立风险因素,通过药物或饮食恢复BCAA平衡是一种很有前景的治疗策略,可改善DKD的进展。
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引用次数: 0
Seven glucagon-like peptide-1 receptor agonists and polyagonists for weight loss in patients with obesity or overweight: an updated systematic review and network meta-analysis of randomized controlled trials 用于肥胖或超重患者减肥的七种胰高血糖素样肽-1 受体激动剂和多拮抗剂:随机对照试验的最新系统综述和网络荟萃分析。
IF 10.8 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-19 DOI: 10.1016/j.metabol.2024.156038
Zeyu Xie , Guimei Zheng , Zhuoru Liang , Mengting Li , Weishang Deng , Weiling Cao
<div><h3>Purpose</h3><div>This study aimed to provide evidence-based support and a reference for the efficacy and safety of seven glucagon-like peptide-1 (GLP-1) receptor agonists and polyagonists for weight loss in patients with obesity or overweight through a network meta-analysis.</div></div><div><h3>Methods</h3><div>Relevant randomized controlled trials (RCTs) with an intervention duration of at least 16 weeks assessing seven GLP-1 receptor agonists and polyagonists (mazdutide, 6 or 4.5 mg; retatrutide, 12 or 8 mg; tirzepatide, 15 or 10 mg; liraglutide, 3.0 mg; semaglutide, 2.4 mg; orforglipron, 45 or 36 mg; and beinaglutide, 0.2 mg) in patient with obesity or overweight was searched using three databases (Cochrane Library, PubMed, and Embase) from creation to August 30, 2024. The primary outcome was the percentage change in body weight from baseline. Secondary outcomes included changes in waist circumference, hemoglobin A1c, and fasting plasma glucose level from baseline; adverse events, serious adverse events, adverse event withdrawal, and hypoglycemic events. We conducted a frequentist random-effects network meta-analysis to analyze the data extracted from the RCTs using Stata 16.1 software.</div></div><div><h3>Results</h3><div>Twenty-seven RCTs of seven GLP-1 receptor agonists and polyagonists and 15,584 patients were included in the network meta-analysis. In terms of efficacy, compared with placebo, retatrutide 12 mg (−22.10 % in body weight and − 17.00 cm in waist circumference), retatrutide 8 mg (−20.70 % and − 15.90 cm), and tirzepatide 15 mg (−16.53 % and − 13.23 cm) were the three most efficacious treatments for reducing body weight and waist circumference. However, these treatments were less effective in patients with type 2 diabetes mellitus (T2DM). In addition, patients with a high body mass index (BMI) or longer treatment cycles exhibited significantly greater weight loss than those with a low BMI or shorter treatment cycles. In terms of safety, patients without T2DM had a higher incidence of adverse events than those with T2DM. None of the interventions increased the incidence of serious adverse or hypoglycemic events (˂54 mg/dL). There was no significant difference in the incidence of adverse event withdrawal for all interventions in head-to-head comparisons. In addition, disparities in race, BMI, and treatment cycles did not significantly increase the incidence of adverse events. Finally, the sensitivity and publication bias analyses indicated that the basic analysis results were reliable.</div></div><div><h3>Conclusion</h3><div>Retatrutide (both doses) and tirzepatide exhibited superior efficacy compared to other GLP-1 receptor agonists and polyagonists in reducing body weight and waist circumference. Patients without T2DM, those with a high BMI, and individuals undergoing longer treatment cycles demonstrated significantly greater weight loss and reductions in waist circumference. Dual or triple receptor agonists (GLP-1 plus
目的:本研究旨在通过网络荟萃分析为七种胰高血糖素样肽-1(GLP-1)受体激动剂和多拮抗剂对肥胖或超重患者减肥的有效性和安全性提供循证支持和参考:评估七种 GLP-1 受体激动剂和多拮抗剂(马兹杜肽,6 或 4.5 毫克;雷他曲肽,12 或 8 毫克;替泽帕肽,15 或 10 毫克;利拉鲁肽,3.该研究使用三个数据库(Cochrane Library、PubMed 和 Embase)对肥胖或超重患者进行了检索,检索时间为创建至 2024 年 8 月 30 日。主要结果是体重与基线相比的百分比变化。次要结果包括腰围、血红蛋白 A1c 和空腹血浆葡萄糖水平与基线相比的变化;不良事件、严重不良事件、不良事件撤消和低血糖事件。我们使用 Stata 16.1 软件进行了频数随机效应网络荟萃分析,以分析从研究性临床试验中提取的数据:网络荟萃分析共纳入了 27 项研究,涉及 7 种 GLP-1 受体激动剂和多拮抗剂,共 15,584 名患者。就疗效而言,与安慰剂相比,雷塔曲肽 12 毫克(体重下降 22.10%,腰围下降 17.00 厘米)、雷塔曲肽 8 毫克(体重下降 20.70%,腰围下降 15.90 厘米)和替泽帕肽 15 毫克(体重下降 16.53%,腰围下降 13.23 厘米)是降低体重和腰围最有效的三种治疗方法。然而,这些疗法对 2 型糖尿病(T2DM)患者的疗效较差。此外,体重指数(BMI)高或治疗周期长的患者的体重减轻幅度明显大于体重指数低或治疗周期短的患者。在安全性方面,无 T2DM 患者的不良反应发生率高于 T2DM 患者。没有一种干预措施会增加严重不良反应或低血糖事件(˂54 mg/dL)的发生率。在头对头比较中,所有干预措施的不良事件停药发生率均无明显差异。此外,种族、体重指数和治疗周期的差异也不会显著增加不良事件的发生率。最后,敏感性和发表偏倚分析表明,基本分析结果是可靠的:结论:与其他GLP-1受体激动剂和多拮抗剂相比,雷特鲁肽(两种剂量)和替泽帕肽在降低体重和腰围方面表现出更优越的疗效。没有 T2DM 的患者、体重指数较高的患者以及治疗周期较长的患者的体重下降幅度和腰围减少幅度明显更大。双受体或三受体激动剂(GLP-1 加葡萄糖依赖性促胰岛素多肽和/或胰高血糖素受体)比 GLP-1 受体激动剂对减轻体重更有效。
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引用次数: 0
Corrigendum to “PCSK7: A novel regulator of apolipoprotein B and a potential target against non-alcoholic fatty liver disease” [Metabolism Volume 150, January 2024, 155736, PMID: 7967646] PCSK7:载脂蛋白 B 的新型调节因子和防治非酒精性脂肪肝的潜在靶点》更正[《新陈代谢》第 150 卷,2024 年 1 月,155736,PMID: 7967646]
IF 10.8 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-19 DOI: 10.1016/j.metabol.2024.156032
Vatsal Sachan , Maïlys LeDévéhat , Anna Roubtsova , Rachid Essalmani , Jean-Francois Laurendeau , Damien Garçon , Delia Susan-Sesiga , Stéphanie Duval , Sahar Mikaeeli , Josée Hamelin , Alexandra Evagelidis , Michael Chong , Guillaume Paré , Elizabeta Chernetsova , Zu-Hua Gao , Isabelle Robillard , Matthieu Ruiz , Vincent Quoc-Huy Trinh , Jennifer L. Estall , May Faraj , Nabil G. Seidah
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引用次数: 0
Inter-organ cross-talk in human cancer cachexia revealed by spatial metabolomics 空间代谢组学揭示人类癌症恶病质中的器官间交叉作用
IF 10.8 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-17 DOI: 10.1016/j.metabol.2024.156034
Na Sun , Tanja Krauss , Claudine Seeliger , Thomas Kunzke , Barbara Stöckl , Annette Feuchtinger , Chaoyang Zhang , Andreas Voss , Simone Heisz , Olga Prokopchuk , Marc E. Martignoni , Klaus-Peter Janssen , Melina Claussnitzer , Hans Hauner , Axel Walch

Background

Cancer cachexia (CCx) presents a multifaceted challenge characterized by negative protein and energy balance and systemic inflammatory response activation. While previous CCx studies predominantly focused on mouse models or human body fluids, there's an unmet need to elucidate the molecular inter-organ cross-talk underlying the pathophysiology of human CCx.

Methods

Spatial metabolomics were conducted on liver, skeletal muscle, subcutaneous and visceral adipose tissue, and serum from cachectic and control cancer patients. Organ-wise comparisons were performed using component, pathway enrichment and correlation network analyses. Inter-organ correlations in CCx altered pathways were assessed using Circos. Machine learning on tissues and serum established classifiers as potential diagnostic biomarkers for CCx.

Results

Distinct metabolic pathway alteration was detected in CCx, with adipose tissues and liver displaying the most significant (P ≤ 0.05) metabolic disturbances. CCx patients exhibited increased metabolic activity in visceral and subcutaneous adipose tissues and liver, contrasting with decreased activity in muscle and serum compared to control patients. Carbohydrate, lipid, amino acid, and vitamin metabolism emerged as highly interacting pathways across different organ systems in CCx. Muscle tissue showed decreased (P ≤ 0.001) energy charge in CCx patients, while liver and adipose tissues displayed increased energy charge (P ≤ 0.001). We stratified CCx patients by severity and metabolic changes, finding that visceral adipose tissue is most affected, especially in cases of severe cachexia. Morphometric analysis showed smaller (P ≤ 0.05) adipocyte size in visceral adipose tissue, indicating catabolic processes. We developed tissue-based classifiers for cancer cachexia specific to individual organs, facilitating the transfer of patient serum as minimally invasive diagnostic markers of CCx in the constitution of the organs.

Conclusions

These findings support the concept of CCx as a multi-organ syndrome with diverse metabolic alterations, providing insights into the pathophysiology and organ cross-talk of human CCx. This study pioneers spatial metabolomics for CCx, demonstrating the feasibility of distinguishing cachexia status at the organ level using serum.
背景:癌症恶病质(CCx)是一个多方面的挑战,其特点是蛋白质和能量负平衡以及全身炎症反应激活。以往的癌症恶病质研究主要集中在小鼠模型或人体体液上,而阐明人体癌症恶病质病理生理学背后的器官间分子交叉对话的需求尚未得到满足:方法:对罹患癌症和对照组癌症患者的肝脏、骨骼肌、皮下和内脏脂肪组织以及血清进行了空间代谢组学研究。利用成分、通路富集和相关网络分析对各组织进行比较。使用 Circos 评估了 CCx 改变通路的器官间相关性。通过对组织和血清进行机器学习,建立了分类器,作为CCx的潜在诊断生物标记物:结果:在CCx患者中发现了不同的代谢途径改变,其中脂肪组织和肝脏的代谢紊乱最为显著(P≤0.05)。与对照组患者相比,CCx 患者内脏、皮下脂肪组织和肝脏中的代谢活动增加,而肌肉和血清中的代谢活动减少。碳水化合物、脂质、氨基酸和维生素代谢在CCx患者的不同器官系统中成为高度交互作用的途径。CCx患者的肌肉组织显示能量电荷减少(P≤0.001),而肝脏和脂肪组织显示能量电荷增加(P≤0.001)。我们根据CCx患者的严重程度和代谢变化对其进行了分层,发现内脏脂肪组织受影响最大,尤其是在严重恶病质的病例中。形态计量分析表明,内脏脂肪组织中的脂肪细胞体积较小(P≤0.05),表明存在分解代谢过程。我们开发了基于组织的癌症恶病质分类器,专门针对单个器官,便于转移患者血清作为器官构成中CCx的微创诊断标记:这些发现支持了癌症恶病质是一种多器官综合征的概念,它具有多种代谢改变,为人类癌症恶病质的病理生理学和器官交叉对话提供了见解。这项研究开创了针对CCx的空间代谢组学,证明了利用血清在器官水平上区分恶病质状态的可行性。
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引用次数: 0
Beyond glucose: The crucial role of redox signaling in β-cell metabolic adaptation 超越葡萄糖:氧化还原信号在β细胞代谢适应中的关键作用。
IF 10.8 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-12 DOI: 10.1016/j.metabol.2024.156027
Blanka Holendová , Barbora Šalovská , Štěpánka Benáková , Lydie Plecitá-Hlavatá

Objective

Redox signaling mediated by reversible oxidative cysteine thiol modifications is crucial for driving cellular adaptation to dynamic environmental changes, maintaining homeostasis, and ensuring proper function. This is particularly critical in pancreatic β-cells, which are highly metabolically active and play a specialized role in whole organism glucose homeostasis. Glucose stimulation in β-cells triggers signals leading to insulin secretion, including changes in ATP/ADP ratio and intracellular calcium levels. Additionally, lipid metabolism and reactive oxygen species (ROS) signaling are essential for β-cell function and health.

Methods

We employed IodoTMT isobaric labeling combined with tandem mass spectrometry to elucidate redox signaling pathways in pancreatic β-cells.

Results

Glucose stimulation significantly increases ROS levels in β-cells, leading to targeted reversible oxidation of proteins involved in key metabolic pathways such as glycolysis, the tricarboxylic acid (TCA) cycle, pyruvate metabolism, oxidative phosphorylation, protein processing in the endoplasmic reticulum (ER), and insulin secretion. Furthermore, the glucose-induced increase in reversible cysteine oxidation correlates with the presence of other post-translational modifications, including acetylation and phosphorylation.

Conclusions

Proper functioning of pancreatic β-cell metabolism relies on fine-tuned regulation, achieved through a sophisticated system of diverse post-translational modifications that modulate protein functions. Our findings demonstrate that glucose induces the production of ROS in pancreatic β-cells, leading to targeted reversible oxidative modifications of proteins. Furthermore, protein activity is modulated by acetylation and phosphorylation, highlighting the complexity of the regulatory mechanisms in β-cell function.
目的:由可逆氧化半胱氨酸巯基修饰介导的氧化还原信号对于推动细胞适应动态环境变化、维持体内平衡和确保正常功能至关重要。这一点对胰腺β细胞尤为重要,因为β细胞代谢高度活跃,在整个机体的葡萄糖稳态中发挥着特殊作用。β细胞中的葡萄糖刺激会触发导致胰岛素分泌的信号,包括 ATP/ADP 比率和细胞内钙水平的变化。此外,脂质代谢和活性氧(ROS)信号对β细胞的功能和健康也至关重要:方法:我们采用 IodoTMT 等位标记结合串联质谱法来阐明胰腺 β 细胞的氧化还原信号通路:结果:葡萄糖刺激可明显增加β细胞中的ROS水平,导致参与糖酵解、三羧酸循环、丙酮酸代谢、氧化磷酸化、内质网(ER)中的蛋白质加工和胰岛素分泌等关键代谢途径的蛋白质发生定向可逆氧化。此外,葡萄糖诱导的可逆半胱氨酸氧化增加与其他翻译后修饰(包括乙酰化和磷酸化)的存在相关:胰岛β细胞新陈代谢的正常运行依赖于微调,而微调是通过调节蛋白质功能的各种翻译后修饰的复杂系统实现的。我们的研究结果表明,葡萄糖会诱导胰岛β细胞产生 ROS,从而导致蛋白质发生有针对性的可逆氧化修饰。此外,蛋白质的活性还受到乙酰化和磷酸化的调节,凸显了β细胞功能调节机制的复杂性。
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Metabolism: clinical and experimental
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