Umbarawan Yogi, Syamsunarno Mas Rizky A A, Obinata Hideru, Yamaguchi Aiko, Sunaga Hiroaki, Matsui Hiroki, Hishiki Takako, Matsuura Tomomi, Koitabashi Norimichi, Obokata Masaru, Hanaoka Hirofumi, Haque Anwarul, Kunimoto Fumio, Tsushima Yoshito, Suematsu Makoto, Kurabayashi Masahiko, Iso Tatsuya
Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan; Faculty of Medicine, Universitas Padjadjaran, Jl. Raya Bandung Sumedang KM 21, Jatinangor, West Java 45363, Indonesia.
Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan; Department of Biochemistry and Molecular Biology, Universitas Padjadjaran, Jl. Raya Bandung Sumedang KM 21, Jatinangor, West Java 45363, Indonesia.
Metabolism. 2017 Dec;77:47-57. doi: 10.1016/j.metabol.2017.09.003. Epub 2017 Sep 20.
Myocardial contractile dysfunction in sepsis has been attributed mainly to increased inflammatory cytokines, insulin resistance, and impaired oxidative phosphorylation of fatty acids (FAs). However, precise molecular mechanisms underlying the cardiac dysfunction in sepsis remain to be determined. We previously reported major shift in myocardial energy substrates from FAs to glucose, and increased hepatic ketogenesis in mice lacking fatty acid-binding protein 4 (FABP4) and FABP5 (DKO).
We sought to determine whether a shift of energy substrates from FAs to glucose and increased availability of ketone bodies are beneficial or detrimental to cardiac function under the septic condition.
Lipopolysaccharide (LPS, 10mg/kg) was intraperitoneally injected into wild-type (WT) and DKO mice. Twelve hours after injection, cardiac function was assessed by echocardiography and serum and hearts were collected for further analyses.
Cardiac contractile function was more deteriorated by LPS injection in DKO mice than WT mice despite comparable changes in pro-inflammatory cytokine production. LPS injection reduced myocardial uptake of FA tracer by 30% in both types of mice, while uptake of the glucose tracer did not significantly change in either group of mice in sepsis. Storage of glycogen and triacylglycerol in hearts was remarkably increased by LPS injection in both mice. Metabolome analysis revealed that LPS-induced suppression of pool size in the TCA cycle was more enhanced in DKO hearts. A tracing study with C-glucose further revealed that LPS injection substantially reduced glucose-derived metabolites in the TCA cycle and related amino acids in DKO hearts. Consistent with these findings, glucose oxidation in vitro was similarly and markedly reduced in both mice. Serum concentration of β-hydroxybutyrate and cardiac expression of genes associated with ketolysis were reduced in septic mice.
Our study demonstrated that LPS-induced cardiac contractile dysfunction is associated with the robust suppression of catabolism of energy substrates including FAs, glucose and ketone bodies and accumulation of glycogen and triacylglycerol in the heart. Thus, a fuel shift from FAs to glucose and/or ketone bodies may be detrimental rather than protective under septic conditions.
脓毒症时心肌收缩功能障碍主要归因于炎症细胞因子增加、胰岛素抵抗以及脂肪酸(FAs)氧化磷酸化受损。然而,脓毒症时心脏功能障碍的确切分子机制仍有待确定。我们之前报道,在缺乏脂肪酸结合蛋白4(FABP4)和脂肪酸结合蛋白5(DKO)的小鼠中,心肌能量底物从脂肪酸向葡萄糖发生了重大转变,且肝脏生酮作用增强。
我们试图确定在脓毒症条件下,能量底物从脂肪酸向葡萄糖的转变以及酮体可用性增加对心脏功能是有益还是有害。
将脂多糖(LPS,10mg/kg)腹腔注射到野生型(WT)和DKO小鼠体内。注射12小时后,通过超声心动图评估心脏功能,并收集血清和心脏进行进一步分析。
尽管促炎细胞因子产生的变化相当,但与野生型小鼠相比,LPS注射使DKO小鼠的心脏收缩功能恶化更严重。LPS注射使两种类型小鼠的心肌对FA示踪剂的摄取减少30%,而脓毒症时两组小鼠对葡萄糖示踪剂的摄取均未显著变化。LPS注射使两种小鼠心脏中的糖原和三酰甘油储存显著增加。代谢组分析显示,LPS诱导的DKO心脏中三羧酸循环库大小的抑制作用增强。用C-葡萄糖进行的示踪研究进一步表明,LPS注射显著减少了DKO心脏中三羧酸循环中葡萄糖衍生的代谢物和相关氨基酸。与这些发现一致,两种小鼠体外葡萄糖氧化同样显著降低。脓毒症小鼠血清β-羟基丁酸浓度和与酮体分解相关的基因在心脏中的表达降低。
我们的研究表明,LPS诱导的心脏收缩功能障碍与包括脂肪酸、葡萄糖和酮体在内的能量底物分解代谢的强烈抑制以及心脏中糖原和三酰甘油的积累有关。因此,在脓毒症条件下,燃料从脂肪酸向葡萄糖和/或酮体的转变可能是有害而非保护性的。