Institute of Medical Science, University of Toronto, Canada.
Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Toronto, Canada.
Shock. 2020 Feb;53(2):137-145. doi: 10.1097/SHK.0000000000001439.
Extensive burn injuries promote an increase in the lipolysis of white adipose tissue (WAT), a complication that enhances postburn hypermetabolism contributing to hyperlipidemia and hepatic steatosis. The systemic increase of free fatty acids (FFAs) due to burn-induced lipolysis and subsequent organ fatty infiltration may culminate in multiple organ dysfunction and, ultimately, death. Thus, reducing WAT lipolysis to diminish the mobilization of FFAs may render an effective means to improve outcomes postburn. Here, we investigated the metabolic effects of Acipimox, a clinically approved drug that suppresses lipolysis via inhibition of hormone-sensitive lipase (HSL). Using a murine model of thermal injury, we show that specific inhibition of HSL with Acipimox effectively suppresses burn-induced lipolysis in the inguinal WAT leading to lower levels of circulating FFAs at 7 days postburn (P < 0.05). The FFA substrate shortage indirectly repressed the thermogenic activation of adipose tissue after injury, reflected by the decrease in protein expression of key browning markers, UCP-1 (P < 0.001) and PGC-1α (P < 0.01). Importantly, reduction of FFA mobilization by Acipimox significantly decreased liver weight and intracellular fat accumulation (P < 0.05), suggesting that it may also improve organ function postburn. Our data validate the pharmacological inhibition of lipolysis as a potentially powerful therapeutic strategy to counteract the detrimental metabolic effects induced by burn.
大面积烧伤会促进白色脂肪组织(WAT)的脂肪分解增加,这是一种并发症,会加重烧伤后的代谢亢进,导致高血脂和脂肪肝。烧伤引起的脂肪分解和随后的器官脂肪浸润导致的体内游离脂肪酸(FFA)的系统性增加,可能最终导致多器官功能障碍,并导致死亡。因此,减少 WAT 的脂肪分解以减少 FFA 的动员可能是改善烧伤后预后的有效方法。在这里,我们研究了 Acipimox 的代谢作用,Acipimox 是一种临床批准的药物,通过抑制激素敏感脂肪酶(HSL)来抑制脂肪分解。使用热损伤的小鼠模型,我们表明,Acipimox 对 HSL 的特异性抑制可有效抑制腹股沟 WAT 中的烧伤诱导的脂肪分解,导致烧伤后 7 天循环 FFA 水平降低(P < 0.05)。FFA 底物短缺间接抑制了损伤后脂肪组织的产热激活,反映在关键褐色标记物 UCP-1(P < 0.001)和 PGC-1α(P < 0.01)的蛋白表达减少。重要的是,Acipimox 减少 FFA 动员可显著降低肝脏重量和细胞内脂肪堆积(P < 0.05),表明它也可能改善烧伤后的器官功能。我们的数据验证了脂肪分解的药理学抑制作为一种潜在的强大治疗策略,以对抗烧伤引起的有害代谢效应。