Department of Internal Medicine/Molecular Medicine and.
Department of Anesthesiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
JCI Insight. 2018 Aug 9;3(15). doi: 10.1172/jci.insight.99292.
Limited understanding of the mechanisms responsible for life-threatening organ and immune failure hampers scientists' ability to design sepsis treatments. Pyruvate dehydrogenase kinase 1 (PDK1) is persistently expressed in immune-tolerant monocytes of septic mice and humans and deactivates mitochondrial pyruvate dehydrogenase complex (PDC), the gate-keeping enzyme for glucose oxidation. Here, we show that targeting PDK with its prototypic inhibitor dichloroacetate (DCA) reactivates PDC; increases mitochondrial oxidative bioenergetics in isolated hepatocytes and splenocytes; promotes vascular, immune, and organ homeostasis; accelerates bacterial clearance; and increases survival. These results indicate that the PDC/PDK axis is a druggable mitochondrial target for promoting immunometabolic and organ homeostasis during sepsis.
对导致危及生命的器官和免疫衰竭的机制的了解有限,这阻碍了科学家设计败血症治疗方法的能力。丙酮酸脱氢酶激酶 1(PDK1)在败血症小鼠和人类的免疫耐受单核细胞中持续表达,并使线粒体丙酮酸脱氢酶复合物(PDC)失活,PDC 是葡萄糖氧化的关键酶。在这里,我们表明,用其原型抑制剂二氯乙酸(DCA)靶向 PDK 可使 PDC 重新激活;增加分离的肝细胞和脾细胞中线粒体氧化生物能;促进血管、免疫和器官的稳态;加速细菌清除;并提高存活率。这些结果表明,PDC/PDK 轴是一种可药物治疗的线粒体靶点,可在败血症期间促进免疫代谢和器官稳态。