School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
Department of Biosciences, Università degli Studi di Milano, Milan, Italy.
Am J Physiol Cell Physiol. 2021 Apr 1;320(4):C547-C553. doi: 10.1152/ajpcell.00458.2020. Epub 2021 Jan 27.
In the past decade, ketogenic diet (KD) has gained some popularity as a potential treatment for a wide range of diseases, including neurological and metabolic disorders, thanks to a beneficial role mainly related to its anti-inflammatory properties. The high-fat and carbohydrate-restricted regimen causes changes in the metabolism, leading, through the β-oxidation of fatty acids, to the hepatic production of ketone bodies (KBs), which are used by many extrahepatic tissues as energy fuels. Once synthetized, KBs are delivered through the systemic circulation to all the tissues of the organism, where they play pleiotropic roles acting directly and indirectly on various targets, and among them ion channels and neurotransmitters. Moreover, they can operate as signaling metabolites and epigenetic modulators. Therefore, it is inappropriate to consider that the KD regimen can improve the patients' clinical condition simply by means of specific and localized effects; rather, it is more correct to think that KBs affect the organism as a whole. In this review, we tried to summarize the recent knowledge of the effects of KBs on various tissues, with a particular attention on the excitable ones, namely the nervous system, heart, and muscles.
在过去的十年中，生酮饮食（KD）因其抗炎特性而具有广泛的治疗作用，包括神经和代谢紊乱，因此受到了一定的关注。高脂肪和低碳水化合物的饮食会导致代谢发生变化，通过脂肪酸的β氧化，导致肝脏产生酮体（KB），许多肝外组织将 KB 作为能量燃料使用。一旦合成，KB 就会通过全身循环输送到机体的所有组织中，在这些组织中，它们通过直接和间接作用于各种靶点发挥多效性作用，其中包括离子通道和神经递质。此外，它们还可以作为信号代谢物和表观遗传调节剂发挥作用。因此，认为 KD 饮食方案可以通过特定和局部的作用来改善患者的临床状况是不合适的；相反，认为 KB 会影响整个机体更为恰当。在这篇综述中，我们试图总结 KB 对各种组织的影响的最新知识，特别关注易兴奋组织，即神经系统、心脏和肌肉。
