Yamane Kazuhiko, Indalao Irene L, Chida Junji, Yamamoto Yoshikazu, Hanawa Masaaki, Kido Hiroshi
Division of Enzyme Chemistry, Institute for Enzyme Research, The University of Tokushima, Tokushima, Japan.
R&D Department, Daiichi Sankyo Healthcare Co., Ltd., Tokyo, Japan.
PLoS One. 2014 May 27;9(5):e98032. doi: 10.1371/journal.pone.0098032. eCollection 2014.
Severe influenza is characterized by cytokine storm and multiorgan failure with metabolic energy disorders and vascular hyperpermeability. In the regulation of energy homeostasis, the pyruvate dehydrogenase (PDH) complex plays an important role by catalyzing oxidative decarboxylation of pyruvate, linking glycolysis to the tricarboxylic acid cycle and fatty acid synthesis, and thus its activity is linked to energy homeostasis. The present study tested the effects of diisopropylamine dichloroacetate (DADA), a new PDH kinase 4 (PDK4) inhibitor, in mice with severe influenza. Infection of mice with influenza A PR/8/34(H1N1) virus resulted in marked down-regulation of PDH activity and ATP level, with selective up-regulation of PDK4 in the skeletal muscles, heart, liver and lungs. Oral administration of DADA at 12-h intervals for 14 days starting immediately after infection significantly restored PDH activity and ATP level in various organs, and ameliorated disorders of glucose and lipid metabolism in the blood, together with marked improvement of survival and suppression of cytokine storm, trypsin up-regulation and viral replication. These results indicate that through PDK4 inhibition, DADA effectively suppresses the host metabolic disorder-cytokine cycle, which is closely linked to the influenza virus-cytokine-trypsin cycle, resulting in prevention of multiorgan failure in severe influenza.
重症流感的特征是细胞因子风暴和多器官功能衰竭,并伴有代谢能量紊乱和血管通透性增加。在能量稳态调节中,丙酮酸脱氢酶(PDH)复合物通过催化丙酮酸的氧化脱羧反应,将糖酵解与三羧酸循环及脂肪酸合成联系起来,发挥着重要作用,因此其活性与能量稳态相关。本研究测试了新型PDH激酶4(PDK4)抑制剂二氯醋酸二异丙胺(DADA)对重症流感小鼠的影响。用甲型PR/8/34(H1N1)流感病毒感染小鼠后,PDH活性和ATP水平显著下调,骨骼肌、心脏、肝脏和肺中的PDK4选择性上调。感染后立即开始每隔12小时口服DADA,持续14天,可显著恢复各器官的PDH活性和ATP水平,改善血液中的葡萄糖和脂质代谢紊乱,同时显著提高生存率,抑制细胞因子风暴、胰蛋白酶上调和病毒复制。这些结果表明,通过抑制PDK4,DADA可有效抑制与流感病毒-细胞因子-胰蛋白酶循环密切相关的宿主代谢紊乱-细胞因子循环,从而预防重症流感中的多器官功能衰竭。