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Khetarpal SA, Vitali C, Levin MG, Klarin D, Park J, Pampana A, Millar JS, Kuwano T, Sugasini D, Subbaiah PV, Billheimer JT, Natarajan P, Rader DJ. Endothelial lipase mediates efficient lipolysis of triglyceride-rich lipoproteins. PLoS Genet 2021; 17:e1009802. [PMID: 34543263 PMCID: PMC8483387 DOI: 10.1371/journal.pgen.1009802] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 09/30/2021] [Accepted: 09/02/2021] [Indexed: 11/18/2022] Open
Abstract
Triglyceride-rich lipoproteins (TRLs) are circulating reservoirs of fatty acids used as vital energy sources for peripheral tissues. Lipoprotein lipase (LPL) is a predominant enzyme mediating triglyceride (TG) lipolysis and TRL clearance to provide fatty acids to tissues in animals. Physiological and human genetic evidence support a primary role for LPL in hydrolyzing TRL TGs. We hypothesized that endothelial lipase (EL), another extracellular lipase that primarily hydrolyzes lipoprotein phospholipids may also contribute to TRL metabolism. To explore this, we studied the impact of genetic EL loss-of-function on TRL metabolism in humans and mice. Humans carrying a loss-of-function missense variant in LIPG, p.Asn396Ser (rs77960347), demonstrated elevated plasma TGs and elevated phospholipids in TRLs, among other lipoprotein classes. Mice with germline EL deficiency challenged with excess dietary TG through refeeding or a high-fat diet exhibited elevated TGs, delayed dietary TRL clearance, and impaired TRL TG lipolysis in vivo that was rescued by EL reconstitution in the liver. Lipidomic analyses of postprandial plasma from high-fat fed Lipg-/- mice demonstrated accumulation of phospholipids and TGs harboring long-chain polyunsaturated fatty acids (PUFAs), known substrates for EL lipolysis. In vitro and in vivo, EL and LPL together promoted greater TG lipolysis than either extracellular lipase alone. Our data positions EL as a key collaborator of LPL to mediate efficient lipolysis of TRLs in humans and mice.
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Affiliation(s)
- Sumeet A. Khetarpal
- Departments of Medicine and Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America,Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts, United States of America
| | - Cecilia Vitali
- Departments of Medicine and Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Michael G. Levin
- Division of Cardiovascular Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America,Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America,Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania, United States of America
| | - Derek Klarin
- Boston VA Healthcare System, Boston, Massachusetts, United States of America,Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America,Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America
| | - Joseph Park
- Departments of Medicine and Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Akhil Pampana
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts, United States of America,Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America,Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America,Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - John S. Millar
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Takashi Kuwano
- Departments of Medicine and Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Dhavamani Sugasini
- Section of Endocrinology, Department of Medicine, University of Illinois at Chicago; Jesse Brown VA Medical Center, Chicago, Illinois, United States of America
| | - Papasani V. Subbaiah
- Section of Endocrinology, Department of Medicine, University of Illinois at Chicago; Jesse Brown VA Medical Center, Chicago, Illinois, United States of America
| | - Jeffrey T. Billheimer
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Pradeep Natarajan
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts, United States of America,Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America,Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, United States of America,Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Daniel J. Rader
- Departments of Medicine and Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America,* E-mail:
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Han X, Ye H. Overview of Lipidomic Analysis of Triglyceride Molecular Species in Biological Lipid Extracts. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2021; 69:8895-8909. [PMID: 33606510 PMCID: PMC8374006 DOI: 10.1021/acs.jafc.0c07175] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Triglyceride (TG) is a class of neutral lipids, which functions as an energy storage depot and is important for cellular growth, metabolism, and function. The composition and content of TG molecular species are crucial factors for nutritional aspects in food chemistry and are directly associated with several diseases, including atherosclerosis, diabetes, obesity, stroke, etc. As a result of the complexities of aliphatic moieties and their different connections/locations to the glycerol backbone in TG molecules, accurate identification of individual TG molecular species and quantitative assessment of TG composition and content are particularly challenging, even at the current stage of lipidomics development. Herein, methods developed for analysis of TG species, such as liquid chromatography-mass spectrometry with a variety of columns and different mass spectrometric techniques, shotgun lipidomics approaches, and ion-mobility-based analysis, are reviewed. Moreover, the potential limitations of the methods are discussed. It is our sincere hope that the overviews and discussions can provide some insights for researchers to select an appropriate approach for TG analysis and can serve as the basis for those who would like to establish a methodology for TG analysis or develop a new method when novel tools become available. Biologically accurate analysis of TG species with an enabling method should lead us toward improving the nutritional quality, revealing the effects of TG on diseases, and uncovering the underlying biochemical mechanisms related to these diseases.
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Affiliation(s)
- Xianlin Han
- Barshop Institute for Longevity and Aging Studies, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229 USA
- Departments of Medicine - Diabetes, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229 USA
| | - Hongping Ye
- Department of Medicine - Nephrology, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229 USA
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Sugasini D, Yang P, Ng D, Khetarpal SA, Vitali C, Rader DJ, Subbaiah PV. Potential role of hepatic lipase in the accretion of docosahexaenoic acid (DHA) by the brain. Biochim Biophys Acta Mol Cell Biol Lipids 2021; 1866:159002. [PMID: 34197964 DOI: 10.1016/j.bbalip.2021.159002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/21/2021] [Accepted: 06/24/2021] [Indexed: 10/21/2022]
Abstract
DHA (docosahexaenoic acid) is an essential fatty acid that is required for the normal development and function of the brain. Because of its inability to synthesize adequate amounts of DHA from the precursors, the brain has to acquire DHA from plasma through the blood brain barrier (BBB). Recent studies demonstrated the presence of a transporter at the BBB that specifically transports DHA into the brain in the form of lysophosphatidylcholine (LPC-DHA). However, the mechanism by which LPC-DHA is generated in the plasma is not known. Our previous studies showed that there are at least three different enzymes - lecithin cholesterol acyltransferase (LCAT), endothelial lipase (EL), and hepatic lipase (HL), which can generate LPC-DHA from sn-2 DHA phosphatidylcholine. Here we determined the relative contributions of these enzymes in the delivery of DHA to the brain by measuring the brain DHA levels in the mice deficient in each of these enzymes. The results show that the brain DHA levels of LCAT-deficient mice or EL-deficient mice were not significantly lower than those of their littermates. However, brain DHA was significantly decreased in HL deficient mice (13.5% of total fatty acids) compared to their littermates (17.1%) (p < 0.002), and further decreased to 8.3% of total fatty acids in mice deficient in both HL and EL. These results suggest that HL activity may be the major source for the generation of LPC-DHA in the plasma necessary for transport into the brain, and EL might contribute to this process in the absence of HL.
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Affiliation(s)
| | - Peng Yang
- Department of Medicine, University of Illinois, Chicago, IL 60612, USA
| | - Dominic Ng
- Department of Medicine, St. Michael's Hospital, University of Toronto, Ontario, Canada
| | - Sumeet A Khetarpal
- Department of Medicine, Division of Translational Medicine and Human Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Cecilia Vitali
- Department of Medicine, Division of Translational Medicine and Human Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Daniel J Rader
- Department of Medicine, Division of Translational Medicine and Human Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Papasani V Subbaiah
- Department of Medicine, University of Illinois, Chicago, IL 60612, USA; Jesse Brown VA Medical Center, Chicago, IL 60612, USA.
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Transcriptomic Analysis of THP-1 Macrophages Exposed to Lipoprotein Hydrolysis Products Generated by Lipoprotein Lipase. Lipids 2017; 52:189-205. [DOI: 10.1007/s11745-017-4238-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Accepted: 02/02/2017] [Indexed: 11/25/2022]
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Maier F, Demmelmair H, Fugmann M, Hellmuth C, Lechner A, Koletzko B, Uhl O. Contribution of glycerophospholipids and sphingomyelin to the circulating NEFA. Prostaglandins Leukot Essent Fatty Acids 2016; 110:55-61. [PMID: 26923087 DOI: 10.1016/j.plefa.2016.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 01/13/2016] [Accepted: 01/26/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Serum nonesterified fatty acids (NEFA) are known to be associated with the development of insulin resistance. Recently, differences in the NEFA profile were found in subjects with history of gestational diabetes (postGDM) and healthy controls. Little is known about the NEFA sources in the postprandial state, which prevails most of the day in humans in modern societies. In the present study, we aimed to explore the potential contributions of glycerophospholipid (GPL) and sphingomyelin (SM) fatty acids to the circulating NEFA. METHODS Serum-samples of 19 postGDM women and 20 controls were obtained in fasting state (t0) and 90 minutes (t90) after an oral glucose tolerance test. Fatty acid composition of NEFA and SM were analyzed with liquid chromatography coupled to triple quadrupole mass spectrometry and GPL by gas chromatography. RESULTS The ratio of individual NEFA at t90 vs. t0 (t90/0-ratio) showed no difference between the two groups but increased with chain-length (7% for C16:1, 82% for C26:3). Only NEFA 10:0 was found with lower concentration at t0 and t90 in postGDM. At t90, long-chain polyunsaturated fatty acid correlated closely between NEFA and GPL in postGDM (20:5, 22:4, 22:5 and 22:6) and controls (20:3, 20:4 and 20:5). Very long-chain fatty acid 24:0 correlated significantly between NEFA and SM in postGDM and controls. Saturated and monounsaturated fatty acids correlated less between NEFA and GPL or SM. CONCLUSIONS The NEFA composition varied highly between fasting and fed state in both groups. GPL appeared to contribute long-chain polyunsaturated fatty acid, while SM appeared to contribute very long-chain fatty acids to the NEFA pool.
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Affiliation(s)
- Felicitas Maier
- Ludwig-Maximilians-University of Munich, Dr. von Hauner Children's Hospital, University of Munich Medical Center, München, Germany
| | - Hans Demmelmair
- Ludwig-Maximilians-University of Munich, Dr. von Hauner Children's Hospital, University of Munich Medical Center, München, Germany
| | - Marina Fugmann
- Ludwig-Maximilians-University of Munich, Diabetes Research Group, Medizinische Klinik und Poliklinik IV, University of Munich Medical Center, Munich, Germany; Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Munich, Germany; German Center for Diabetes Research (DZD), Munich, Germany
| | - Christian Hellmuth
- Ludwig-Maximilians-University of Munich, Dr. von Hauner Children's Hospital, University of Munich Medical Center, München, Germany
| | - Andreas Lechner
- Ludwig-Maximilians-University of Munich, Diabetes Research Group, Medizinische Klinik und Poliklinik IV, University of Munich Medical Center, Munich, Germany; Clinical Cooperation Group Type 2 Diabetes, Helmholtz Zentrum München, Munich, Germany; German Center for Diabetes Research (DZD), Munich, Germany
| | - Berthold Koletzko
- Ludwig-Maximilians-University of Munich, Dr. von Hauner Children's Hospital, University of Munich Medical Center, München, Germany.
| | - Olaf Uhl
- Ludwig-Maximilians-University of Munich, Dr. von Hauner Children's Hospital, University of Munich Medical Center, München, Germany
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Abstract
PURPOSE OF REVIEW A major step in energy metabolism is hydrolysis of triacylglycerol-rich lipoproteins (TRLs) to release fatty acids that can be used or stored. This is accomplished by lipoprotein lipase (LPL) at 'binding lipolysis sites' at the vascular endothelium. A multitude of interactions are involved in this seemingly simple reaction. Recent advances in the understanding of some of these factors will be discussed in an attempt to build a comprehensive picture. RECENT FINDINGS The first event in catabolism of TRLs is that they dock at the vascular endothelium. This requires LPL and GPIHBP1, the endothelial transporter of LPL.Kinetic studies in rats with labeled chylomicrons showed that once a chylomicron has docked in the heart it stays for minutes and a large number of triacylglycerol molecules are split. The distribution of binding between tissues reflects the amount of LPL, as evident from studies with mutant mice.Clearance of TRLs is often slowed down in metabolic disease, as was demonstrated both in mice and men. In mice, this was directly connected to decreased amounts of endothelial LPL. SUMMARY The LPL system is central in energy metabolism and results from interplay between several factors. Rapid and exciting progress is being made.
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Affiliation(s)
- Gunilla Olivecrona
- Department of Medical Biosciences/Physiological Chemistry, Umeå University, Umeå, Sweden
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Huang HY, Zhao GP, Liu RR, Li QH, Zheng MQ, Li SF, Liang Z, Zhao ZH, Wen J. Brain Natriuretic Peptide Stimulates Lipid Metabolism through Its Receptor NPR1 and the Glycerolipid Metabolism Pathway in Chicken Adipocytes. Biochemistry 2015; 54:6622-30. [PMID: 26463554 DOI: 10.1021/acs.biochem.5b00714] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Brain natriuretic peptide (BNP) is related to lipid metabolism in mammals, but its effect and the molecular mechanisms underlying it in chickens are incompletely understood. We found that the level of natriuretic peptide precursor B (NPPB, which encodes BNP) mRNA expression in high-abdominal-fat chicken groups was significantly higher than that of low-abdominal-fat groups. Partial correlations indicated that changes in the weight of abdominal fat were positively correlated with NPPB mRNA expression level. In vitro, compared with the control group, preadipocytes with NPPB interference showed reduced levels of proliferation, differentiation, and glycerin in media. Treatments of cells with BNP led to enhanced proliferation and differentiation of cells and glycerin concentration, and mRNA expression of its receptor natriuretic peptide receptor 1 (NPR1) was upregulated significantly. In cells exposed to BNP, 482 differentially expressed genes were identified compared with controls without BNP. Four genes known to be related to lipid metabolism (diacylglycerol kinase; lipase, endothelial; 1-acylglycerol-3-phosphate O-acyltransferase 1; and 1-acylglycerol-3-phosphate O-acyltransferase 2) were enriched in the glycerolipid metabolism pathway and expressed differentially. In conclusion, BNP stimulates the proliferation, differentiation, and lipolysis of preadipocytes through upregulation of the levels of expression of its receptor NPR1 and key genes enriched in the glycerolipid metabolic pathway.
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Affiliation(s)
- H Y Huang
- Institute of Animal Sciences, Chinese Academy of Agricultural Sciences , Beijing 100193, P. R. China.,Institute of Poultry Science, Chinese Academy of Agriculture Sciences , Jiangsu 225125, P. R. China
| | - G P Zhao
- Institute of Animal Sciences, Chinese Academy of Agricultural Sciences , Beijing 100193, P. R. China.,State Key Laboratory of Animal Nutrition , Beijing 100193, P. R. China
| | - R R Liu
- Institute of Animal Sciences, Chinese Academy of Agricultural Sciences , Beijing 100193, P. R. China.,State Key Laboratory of Animal Nutrition , Beijing 100193, P. R. China
| | - Q H Li
- Institute of Animal Sciences, Chinese Academy of Agricultural Sciences , Beijing 100193, P. R. China.,State Key Laboratory of Animal Nutrition , Beijing 100193, P. R. China
| | - M Q Zheng
- Institute of Animal Sciences, Chinese Academy of Agricultural Sciences , Beijing 100193, P. R. China.,State Key Laboratory of Animal Nutrition , Beijing 100193, P. R. China
| | - S F Li
- Institute of Poultry Science, Chinese Academy of Agriculture Sciences , Jiangsu 225125, P. R. China
| | - Z Liang
- Institute of Poultry Science, Chinese Academy of Agriculture Sciences , Jiangsu 225125, P. R. China
| | - Z H Zhao
- Institute of Poultry Science, Chinese Academy of Agriculture Sciences , Jiangsu 225125, P. R. China
| | - J Wen
- Institute of Animal Sciences, Chinese Academy of Agricultural Sciences , Beijing 100193, P. R. China.,State Key Laboratory of Animal Nutrition , Beijing 100193, P. R. China
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Yang P, Subbaiah PV. Regulation of hepatic lipase activity by sphingomyelin in plasma lipoproteins. Biochim Biophys Acta Mol Cell Biol Lipids 2015; 1851:1327-36. [PMID: 26193433 DOI: 10.1016/j.bbalip.2015.07.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 06/25/2015] [Accepted: 07/09/2015] [Indexed: 11/25/2022]
Abstract
Hepatic lipase (HL) is an important enzyme in the clearance of triacylglycerol (TAG) from the circulation, and has been proposed to have pro-atherogenic as well as anti-atherogenic properties. It hydrolyzes both phospholipids and TAG of lipoproteins, and its activity is negatively correlated with HDL levels. Although it is known that HL acts preferentially on HDL lipids, the basis for this specificity is not known, since it does not require any specific apoprotein for activity. In this study, we tested the hypothesis that sphingomyelin (SM), whose concentration is much higher in VLDL and LDL compared to HDL, is an inhibitor of HL, and that this could explain the lipoprotein specificity of the enzyme. The results presented show that the depletion of SM from normal lipoproteins activated the HL roughly in proportion to their SM content. SM depletion stimulated the hydrolysis of both phosphatidylcholine (PC) and TAG, although the PC hydrolysis was stimulated more. In the native lipoproteins, HL showed specificity for PC species containing polyunsaturated fatty acids at sn-2 position, and produced more unsaturated lyso PC species. The enzyme also showed preferential hydrolysis of certain TAG species over others. SM depletion affected the specificity of the enzyme towards PC and TAG species modestly. These results show that SM is a physiological inhibitor of HL activity in lipoproteins and that the specificity of the enzyme towards HDL is at least partly due to its low SM content.
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Affiliation(s)
- Peng Yang
- Section of Endocrinology and Metabolism, Department of Medicine, University of Illinois at Chicago, 1819 West Polk M/C 797, Chicago, United States; Jesse Brown VA Medical Center, Chicago, IL, United States
| | - Papasani V Subbaiah
- Section of Endocrinology and Metabolism, Department of Medicine, University of Illinois at Chicago, 1819 West Polk M/C 797, Chicago, United States; Jesse Brown VA Medical Center, Chicago, IL, United States.
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Soufi N, Hall AM, Chen Z, Yoshino J, Collier SL, Mathews JC, Brunt EM, Albert CJ, Graham MJ, Ford DA, Finck BN. Inhibiting monoacylglycerol acyltransferase 1 ameliorates hepatic metabolic abnormalities but not inflammation and injury in mice. J Biol Chem 2014; 289:30177-88. [PMID: 25213859 DOI: 10.1074/jbc.m114.595850] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Abnormalities in hepatic lipid metabolism and insulin action are believed to play a critical role in the etiology of nonalcoholic steatohepatitis. Monoacylglycerol acyltransferase (MGAT) enzymes convert monoacylglycerol to diacylglycerol, which is the penultimate step in one pathway for triacylglycerol synthesis. Hepatic expression of Mogat1, which encodes an MGAT enzyme, is increased in the livers of mice with hepatic steatosis, and knocking down Mogat1 improves glucose metabolism and hepatic insulin signaling, but whether increased MGAT activity plays a role in the etiology of nonalcoholic steatohepatitis is unclear. To examine this issue, mice were placed on a diet containing high levels of trans fatty acids, fructose, and cholesterol (HTF-C diet) or a low fat control diet for 4 weeks. Mice were injected with antisense oligonucleotides (ASOs) to knockdown Mogat1 or a scrambled ASO control for 12 weeks while remaining on diet. The HTF-C diet caused glucose intolerance, hepatic steatosis, and induced hepatic gene expression markers of inflammation, macrophage infiltration, and stellate cell activation. Mogat1 ASO treatment, which suppressed Mogat1 expression in liver and adipose tissue, attenuated weight gain, improved glucose tolerance, improved hepatic insulin signaling, and decreased hepatic triacylglycerol content compared with control ASO-treated mice on HTF-C chow. However, Mogat1 ASO treatment did not reduce hepatic diacylglycerol, cholesterol, or free fatty acid content; improve histologic measures of liver injury; or reduce expression of markers of stellate cell activation, liver inflammation, and injury. In conclusion, inhibition of hepatic Mogat1 in HTF-C diet-fed mice improves hepatic metabolic abnormalities without attenuating liver inflammation and injury.
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Affiliation(s)
| | | | | | | | | | - James C Mathews
- Pathology and Immunology, Washington University School of Medicine, Saint Louis, Missouri 63110
| | - Elizabeth M Brunt
- Pathology and Immunology, Washington University School of Medicine, Saint Louis, Missouri 63110
| | - Carolyn J Albert
- the Edward A. Doisy Department of Biochemistry and Molecular Biology, Saint Louis University School of Medicine, Saint Louis, Missouri 63104, and
| | - Mark J Graham
- ISIS Pharmaceuticals Inc., Carlsbad, California 92008
| | - David A Ford
- the Edward A. Doisy Department of Biochemistry and Molecular Biology, Saint Louis University School of Medicine, Saint Louis, Missouri 63104, and
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