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Lodewyckx P, Issa J, Gaschignard M, Lamireau D, De Lonlay P, Servais A, Barth M, Courapied S, Morin G, Benbrik N, Maillot F, Babuty D, Labarthe F, Lefort B. Systemic primary carnitine deficiency induces severe arrhythmia due to shortening of QT interval. Mol Genet Metab 2023; 140:107733. [PMID: 37979236 DOI: 10.1016/j.ymgme.2023.107733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND Systemic primary carnitine deficiency (PCD) is characterized by cardiomyopathy and arrhythmia. Without carnitine supplementation, progression is usually towards fatal cardiac decompensation. While the cardiomyopathy is most likely secondary to energy deficiency, the mechanism of arrhythmia is unclear, and may be related to a short QT interval. OBJECTIVE We aim to describe rhythmic manifestations at diagnosis and with carnitine supplementation. METHODS French patients diagnosed for PCD were retrospectively included. Clinical and para clinical data at diagnosis and during follow-up were collected. Electrocardiograms with QT interval measurements were blinded reviewed by two paediatric cardiologists. RESULTS Nineteen patients (median age at diagnosis 2.3 years (extremes 0.3-28.9)) followed in 8 French centres were included. At diagnosis, 21% of patients (4/19) had arrhythmia (2 ventricular fibrillations, 1 ventricular tachycardia and 1 sudden death), and 84% (16/19) had cardiomyopathy. Six electrocardiograms before treatment out of 11 available displayed a short QT (QTc < 340 ms). Median corrected QTc after carnitine supplementation was 404 ms (extremes 341-447) versus 350 ms (extremes 282-421) before treatment (p < 0.001). The whole QTc was prolonged, and no patient reached the criterion of short QT syndrome with carnitine supplementation. Three patients died, probably from rhythmic cause without carnitine supplementation (two extra-hospital sudden deaths and one non-recoverable rhythmic storm before carnitine supplementation), whereas no rhythmic complication occurred in patients with carnitine supplementation. CONCLUSION PCD is associated with shortening of the QT interval inducing severe arrhythmia. A potential explanation would be a toxic effect of accumulated fatty acid and metabolites on ionic channels embedded in the cell membrane. Carnitine supplementation normalizes the QTc and prevents arrhythmia. Newborn screening of primary carnitine deficiency would prevent avoidable deaths.
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Affiliation(s)
- Pierre Lodewyckx
- Institut des Cardiopathies Congénitales de Tours and FHU PRECICARE, CHU Tours, Tours, France
| | - Jean Issa
- Institut des Cardiopathies Congénitales de Tours and FHU PRECICARE, CHU Tours, Tours, France
| | | | | | - Pascale De Lonlay
- Maladie métabolique, Hôpital Necker Enfant Malade, APHP, Université Paris Cité, Filière G2M, MetabERN, Paris, France
| | - Aude Servais
- Maladie métabolique, Hôpital Necker Enfant Malade, APHP, Université Paris Cité, Filière G2M, MetabERN, Paris, France
| | | | - Sandy Courapied
- Maladie métabolique, CHU Lille, Filière G2M, MetabERN, Lille, France
| | | | - Nadir Benbrik
- Fédération cardiologie pédiatrique, CHU Nantes, Nantes, France
| | - François Maillot
- CRMR Maladies Héréditaires du Métabolisme ToTeM, CHU Tours, Tours, France
| | | | - François Labarthe
- CRMR Maladies Héréditaires du Métabolisme ToTeM, CHU Tours, Tours, France; INSERM UMR 1069, Université de Tours, Tours, France
| | - Bruno Lefort
- Institut des Cardiopathies Congénitales de Tours and FHU PRECICARE, CHU Tours, Tours, France; INSERM UMR 1069, Université de Tours, Tours, France.
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2
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Issa J, Lodewyckx P, Blasco H, Benz‐de‐Bretagne I, Labarthe F, Lefort B. Increased acylcarnitines in infant heart failure indicate fatty acid oxidation inhibition: towards therapeutic options? ESC Heart Fail 2023; 10:3114-3122. [PMID: 37614055 PMCID: PMC10567663 DOI: 10.1002/ehf2.14449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 06/07/2023] [Accepted: 06/08/2023] [Indexed: 08/25/2023] Open
Abstract
AIMS Heart failure in adults is characterized by reduction of long-chain fatty acid oxidation in favour of carbohydrate metabolism. This adaptive phenomenon becomes maladaptive because energy conversion decreases and lipid toxic derivatives known to impair cardiac function are accumulating. No data are available concerning metabolic modification in heart failure in children. METHODS AND RESULTS In order to evaluate the fatty acid oxidation in children suffering from heart failure, acylcarnitine profiles on dried blood spots were obtained from children under 16 years old with dilated cardiomyopathy and clinical heart failure (DCM-HF) and control children. Nine children were included in the DCM-HF group and eight in the control group. Acylcarnitine profiles revealed a significant 3.1-fold increase of total acylcarnitines (sum of C3 to C18 acylcarnitine species) in DCM-HF children compared with controls. This result persisted considering the sum of long-chain acylcarnitines (sum of C14 to C18 species), medium-chain acylcarnitines (sum of C8 to C12 species), and short-chain acylcarnitines (sum of C3 to C6 species), respectively, 2.0-, 2.6-, and 1.9-fold increase compared with the control group. A significant linear correlation was found between left ventricular dilatation or ejection fraction and acylcarnitines accumulation. Finally, acylcarnitine ratio C16OH/C16 and C18OH/C18 enhanced in the DCM-HF group, suggesting a diminution of the long-chain hydroxyl acyl-CoA dehydrogenase activity. CONCLUSIONS Our results suggest down-regulation of fatty acid oxidation in children with heart failure. Such lipidomic alteration could worsen heart function and may suggest considering a metabolic treatment of heart failure in children.
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Affiliation(s)
- Jean Issa
- Institut des Cardiopathies Congénitales de Tours, Hôpital Gatien de ClochevilleCHU Tours49 Boulevard BérangerTours37000France
- Université François RabelaisToursFrance
| | - Pierre Lodewyckx
- Institut des Cardiopathies Congénitales de Tours, Hôpital Gatien de ClochevilleCHU Tours49 Boulevard BérangerTours37000France
- Université François RabelaisToursFrance
| | - Hélène Blasco
- Université François RabelaisToursFrance
- Service de Biochimie et Biologie MoléculaireCHU ToursToursFrance
| | | | - François Labarthe
- Université François RabelaisToursFrance
- Département de PédiatrieCHU de ToursToursFrance
- INSERM UMR 1069ToursFrance
| | - Bruno Lefort
- Institut des Cardiopathies Congénitales de Tours, Hôpital Gatien de ClochevilleCHU Tours49 Boulevard BérangerTours37000France
- Université François RabelaisToursFrance
- INSERM UMR 1069ToursFrance
- FHU PreciCareToursFrance
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3
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Vianey-Saban C, Guffon N, Fouilhoux A, Acquaviva C. Fifty years of research on mitochondrial fatty acid oxidation disorders: The remaining challenges. J Inherit Metab Dis 2023; 46:848-873. [PMID: 37530674 DOI: 10.1002/jimd.12664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 07/19/2023] [Accepted: 07/26/2023] [Indexed: 08/03/2023]
Abstract
Since the identification of the first disorder of mitochondrial fatty acid oxidation defects (FAOD) in 1973, more than 20 defects have been identified. Although there are some differences, most FAOD have similar clinical signs, which are mainly due to energy depletion and toxicity of accumulated metabolites. However, some of them have an unusual clinical phenotype or specific clinical signs. This manuscript focuses on what we have learnt so far on the pathophysiology of these disorders, which present with clinical signs that are not typical of categorical FAOD. It also highlights that some disorders have not yet been identified and tries to make assumptions to explain why. It also deals with new treatments under consideration in FAOD, including triheptanoin and similar anaplerotic substrates, ketone body treatments, RNA and gene therapy approaches. Finally, it suggests challenges for the diagnosis of FAOD in the coming years, both for symptomatic patients and for those diagnosed through newborn screening. The ultimate goal would be to identify all the patients born with FAOD and ensure for them the best possible quality of life.
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Affiliation(s)
- Christine Vianey-Saban
- Biochemical and Molecular Biology Laboratory, Metabolic Inborn Errors of Metabolism Unit, Groupement Hospitalier Est, CHU de Lyon, Bron, France
| | - Nathalie Guffon
- National Reference Centre for Hereditary Metabolic Diseases, Groupement Hospitalier Est, CHU de Lyon, Bron, France
| | - Alain Fouilhoux
- National Reference Centre for Hereditary Metabolic Diseases, Groupement Hospitalier Est, CHU de Lyon, Bron, France
| | - Cécile Acquaviva
- Biochemical and Molecular Biology Laboratory, Metabolic Inborn Errors of Metabolism Unit, Groupement Hospitalier Est, CHU de Lyon, Bron, France
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4
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Angelini A, Saha PK, Jain A, Jung SY, Mynatt RL, Pi X, Xie L. PHDs/CPT1B/VDAC1 axis regulates long-chain fatty acid oxidation in cardiomyocytes. Cell Rep 2021; 37:109767. [PMID: 34610308 PMCID: PMC8658754 DOI: 10.1016/j.celrep.2021.109767] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 05/19/2021] [Accepted: 09/02/2021] [Indexed: 12/23/2022] Open
Abstract
Cardiac metabolism is a high-oxygen-consuming process, showing a preference for long-chain fatty acid (LCFA) as the fuel source under physiological conditions. However, a metabolic switch (favoring glucose instead of LCFA) is commonly reported in ischemic or late-stage failing hearts. The mechanism regulating this metabolic switch remains poorly understood. Here, we report that loss of PHD2/3, the cellular oxygen sensors, blocks LCFA mitochondria uptake and β-oxidation in cardiomyocytes. In high-fat-fed mice, PHD2/3 deficiency improves glucose metabolism but exacerbates the cardiac defects. Mechanistically, we find that PHD2/3 bind to CPT1B, a key enzyme of mitochondrial LCFA uptake, promoting CPT1B-P295 hydroxylation. Further, we show that CPT1B-P295 hydroxylation is indispensable for its interaction with VDAC1 and LCFA β-oxidation. Finally, we demonstrate that a CPT1B-P295A mutant constitutively binds to VDAC1 and rescues LCFA metabolism in PHD2/3-deficient cardiomyocytes. Together, our data identify an oxygen-sensitive regulatory axis involved in cardiac metabolism.
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Affiliation(s)
- Aude Angelini
- Department of Medicine, Section of Athero & Lipo, Baylor College of Medicine, Houston, TX 77030, USA; Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX 77030, USA
| | - Pradip K Saha
- Department of Medicine, Division of Diabetes, Endocrinology & Metabolism, Diabetes Research Center, Baylor College of Medicine, Houston, TX 77030, USA
| | - Antrix Jain
- Department of Biochemistry and Molecular Biology, Mass Spectrometry Proteomics Core, Baylor College of Medicine, Houston, TX 77030, USA
| | - Sung Yun Jung
- Department of Biochemistry and Molecular Biology, Mass Spectrometry Proteomics Core, Baylor College of Medicine, Houston, TX 77030, USA
| | - Randall L Mynatt
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
| | - Xinchun Pi
- Department of Medicine, Section of Athero & Lipo, Baylor College of Medicine, Houston, TX 77030, USA; Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX 77030, USA
| | - Liang Xie
- Department of Medicine, Section of Athero & Lipo, Baylor College of Medicine, Houston, TX 77030, USA; Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX 77030, USA.
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5
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Raimo S, Zura-Miller G, Fezelinia H, Spruce LA, Zakopoulos I, Mohsen AW, Vockley J, Ischiropoulos H. Mitochondrial morphology, bioenergetics and proteomic responses in fatty acid oxidation disorders. Redox Biol 2021; 41:101923. [PMID: 33725513 PMCID: PMC7970426 DOI: 10.1016/j.redox.2021.101923] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 02/22/2021] [Accepted: 02/26/2021] [Indexed: 12/30/2022] Open
Abstract
Mutations in nuclear genes encoding for mitochondrial proteins very long-chain acyl-CoA dehydrogenase (VLCAD) and trifunctional protein (TFP) cause rare autosomal recessive disorders. Studies in fibroblasts derived from patients with mutations in VLCAD and TFP exhibit mitochondrial defects. To gain insights on pathological changes that account for the mitochondrial deficits we performed quantitative proteomic, biochemical, and morphometric analyses in fibroblasts derived from subjects with three different VLCAD and three different TFP mutations. Proteomic data that was corroborated by antibody-based detection, indicated reduced levels of VLCAD and TFP protein in cells with VLCAD and TFP mutations respectively, which in part accounted for the diminished fatty acid oxidation capacity. Decreased mitochondrial respiratory capacity in cells with VLCAD and TFP mutations was quantified after glucose removal and cells with TFP mutations had lower levels of glycogen. Despite these energetic deficiencies, the cells with VLCAD and TFP mutations did not exhibit changes in mitochondria morphology, distribution, fusion and fission, quantified by either confocal or transmission electron microscopy and corroborated by proteomic and antibody-based protein analysis. Fibroblasts with VLCAD and to a lesser extend cells with TFP mutations had increased levels of mitochondrial respiratory chain proteins and proteins that facilitate the assembly of respiratory complexes. With the exception of reduced levels of catalase and glutathione S-transferase theta-1 in cells with TFP mutations, the levels of 45 proteins across all major intracellular antioxidant networks were similar between cells with VLCAD and TFP mutations and non-disease controls. Collectively the data indicate that despite the metabolic deficits, cells with VLCAD and TFP mutations maintain their proteomic integrity to preserve cellular and mitochondria architecture, support energy production and protect against oxidative stress.
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Affiliation(s)
- Serena Raimo
- Children's Hospital of Philadelphia Research Institute and Division of Neonatology, Departments of Pediatrics and Systems Pharmacology and Translational Therapeutics, the Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Gabriella Zura-Miller
- Children's Hospital of Philadelphia Research Institute and Division of Neonatology, Departments of Pediatrics and Systems Pharmacology and Translational Therapeutics, the Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Hossein Fezelinia
- Proteomics Core Facility, Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Biomedical Health and Informatics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Lynn A Spruce
- Proteomics Core Facility, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Iordanis Zakopoulos
- Children's Hospital of Philadelphia Research Institute and Division of Neonatology, Departments of Pediatrics and Systems Pharmacology and Translational Therapeutics, the Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Al-Walid Mohsen
- Division of Medical Genetics, Department of Pediatrics, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15224, USA; Department of Human Genetics, School of Public Health, Pittsburgh, PA 15261, USA
| | - Jerry Vockley
- Division of Medical Genetics, Department of Pediatrics, School of Medicine, University of Pittsburgh, Pittsburgh, PA 15224, USA; Department of Human Genetics, School of Public Health, Pittsburgh, PA 15261, USA
| | - Harry Ischiropoulos
- Children's Hospital of Philadelphia Research Institute and Division of Neonatology, Departments of Pediatrics and Systems Pharmacology and Translational Therapeutics, the Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
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6
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Amaral AU, Wajner M. Recent Advances in the Pathophysiology of Fatty Acid Oxidation Defects: Secondary Alterations of Bioenergetics and Mitochondrial Calcium Homeostasis Caused by the Accumulating Fatty Acids. Front Genet 2020; 11:598976. [PMID: 33329744 PMCID: PMC7729159 DOI: 10.3389/fgene.2020.598976] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 11/03/2020] [Indexed: 12/18/2022] Open
Abstract
Deficiencies of medium-chain acyl-CoA dehydrogenase, mitochondrial trifunctional protein, isolated long-chain 3-hydroxyacyl-CoA dehydrogenase, and very long-chain acyl-CoA dehydrogenase activities are considered the most frequent fatty acid oxidation defects (FAOD). They are biochemically characterized by the accumulation of medium-chain, long-chain hydroxyl, and long-chain fatty acids and derivatives, respectively, in tissues and biological fluids of the affected patients. Clinical manifestations commonly include hypoglycemia, cardiomyopathy, and recurrent rhabdomyolysis. Although the pathogenesis of these diseases is still poorly understood, energy deprivation secondary to blockage of fatty acid degradation seems to play an important role. However, recent evidence indicates that the predominant fatty acids accumulating in these disorders disrupt mitochondrial functions and are involved in their pathophysiology, possibly explaining the lactic acidosis, mitochondrial morphological alterations, and altered mitochondrial biochemical parameters found in tissues and cultured fibroblasts from some affected patients and also in animal models of these diseases. In this review, we will update the present knowledge on disturbances of mitochondrial bioenergetics, calcium homeostasis, uncoupling of oxidative phosphorylation, and mitochondrial permeability transition induction provoked by the major fatty acids accumulating in prevalent FAOD. It is emphasized that further in vivo studies carried out in tissues from affected patients and from animal genetic models of these disorders are necessary to confirm the present evidence mostly achieved from in vitro experiments.
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Affiliation(s)
- Alexandre Umpierrez Amaral
- Programa de Pós-Graduação em Ciências Biológicas: Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Departamento de Ciências Biológicas, Universidade Regional Integrada do Alto Uruguai e das Missões, Erechim, Brazil
| | - Moacir Wajner
- Programa de Pós-Graduação em Ciências Biológicas: Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- Serviço de Genética Médica, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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7
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Zhao G, Cheng D, Wang Y, Cao Y, Xiang S, Yu Q. A metabolomic study for chronic heart failure patients based on a dried blood spot mass spectrometry approach. RSC Adv 2020; 10:19621-19628. [PMID: 35515477 PMCID: PMC9054045 DOI: 10.1039/c9ra10684g] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 04/23/2020] [Indexed: 12/24/2022] Open
Abstract
Objective: a dried blood spot (DBS) method integrated with direct infusion mass spectrometry (MS) focused on a metabolomic analysis was applied to detect and compare the difference of metabolites between the heart failure (HF) patients and non-HF patients in order to facilitate the early detection of heart failures, provide targeted intervention and offer prognostic insights. Methods: the method we used was an untargeted metabolic approach. The dry blood spot mass spectrometry (DBS) was used to analyze 23 types of amino acids and 26 types of carnitine in blood samples. In the current study, 49 metabolites were selected to establish the PLS-DA model to compare the differences between the 117 HF patients and 118 non-HF patients, which inclined to detect the difference between the two groups. Multiple algorithms were run for selecting different metabolites as potential biomarkers. Ten-fold cross validation method was used to verify and evaluate the selected potential biomarkers. Results: through significant analysis of the microarrays (SAM) and analysis of 9 parameters, 8 metabolites showed significant discrepancies between the HF and non-HF groups. Among these metabolites, the levels of 5 metabolites were increased, and the other 3 metabolites were decreased in the HF group compared with the non-HF group. However, 7 metabolites including Asn, C0, C14, C4DC, C5-OH, C6 and Glu were selected to distinguish the HF group from the non-HF group with specificity and sensitivity of 0.8475 and 0.8974, respectively. Conclusion: metabolomic study for chronic heart failure (CHF) patients based on the dried blood spot mass spectrometry approach would be beneficial to understand the metabolic pathway of HF, and probably work as biomarkers to predict the prognosis of HF and provide the basis for an individualized treatment. A dried blood spot method with mass spectrometry focused on metabolomics analysis was applied to detect and compare the difference in metabolites between heart failure (HF) patients and non-HF patients in order to facilitate the early detection and treatment of heart failure.![]()
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Affiliation(s)
- Gaowa Zhao
- Department of Cardiology, Affiliated Zhongshan Hospital of Dalian University Jiefang Street 6, Zhongshan District Dalian 116001 China +86-411-62893555 +86-411-62887018.,Medical College, Dalian University Dalian 116622 China
| | - Dong Cheng
- Department of Cardiology, Affiliated Zhongshan Hospital of Dalian University Jiefang Street 6, Zhongshan District Dalian 116001 China +86-411-62893555 +86-411-62887018.,Medical College, Dalian University Dalian 116622 China
| | - Yu Wang
- Department of Cardiology, Affiliated Zhongshan Hospital of Dalian University Jiefang Street 6, Zhongshan District Dalian 116001 China +86-411-62893555 +86-411-62887018.,Dalian Medical University Dalian 116044 China
| | - Yalan Cao
- Department of Cardiology, Affiliated Zhongshan Hospital of Dalian University Jiefang Street 6, Zhongshan District Dalian 116001 China +86-411-62893555 +86-411-62887018.,Zunyi Medical University Zunyi 563003 China
| | - Shuting Xiang
- Department of Cardiology, Affiliated Zhongshan Hospital of Dalian University Jiefang Street 6, Zhongshan District Dalian 116001 China +86-411-62893555 +86-411-62887018.,Zunyi Medical University Zunyi 563003 China
| | - Qin Yu
- Department of Cardiology, Affiliated Zhongshan Hospital of Dalian University Jiefang Street 6, Zhongshan District Dalian 116001 China +86-411-62893555 +86-411-62887018
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8
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McCoin CS, Gillingham MB, Knotts TA, Vockley J, Ono-Moore KD, Blackburn ML, Norman JE, Adams SH. Blood cytokine patterns suggest a modest inflammation phenotype in subjects with long-chain fatty acid oxidation disorders. Physiol Rep 2020; 7:e14037. [PMID: 30912279 PMCID: PMC6434073 DOI: 10.14814/phy2.14037] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 03/04/2019] [Accepted: 03/05/2019] [Indexed: 12/17/2022] Open
Abstract
Excessive cellular accumulation or exposure to lipids such as long‐chain acylcarnitines (LCACs), ceramides, and others is implicated in cell stress and inflammation. Such a situation might manifest when there is a significant mismatch between long‐chain fatty acid (LCFA) availability versus storage and oxidative utilization; for example, in cardiac ischemia, increased LCACs may contribute to tissue cell stress and infarct damage. Perturbed LCFAβ‐oxidation is also seen in fatty acid oxidation disorders (FAODs). FAODs typically manifest with fasting‐ or stress‐induced symptoms, and patients can manage many symptoms through control of diet and physical activity. However, episodic clinical events involving cardiac and skeletal muscle myopathies are common and can present without an obvious molecular trigger. We have speculated that systemic or tissue‐specific lipotoxicity and activation of inflammation pathways contribute to long‐chain FAOD pathophysiology. With this in mind, we characterized inflammatory phenotype (14 blood plasma cytokines) in resting, overnight‐fasted (~10 h), or exercise‐challenged subjects with clinically well‐controlled long‐chain FAODs (n = 12; 10 long‐chain 3‐hydroxyacyl‐CoA dehydrogenase [LCHAD]; 2 carnitine palmitoyltransferase 2 [CPT2]) compared to healthy controls (n = 12). Across experimental conditions, concentrations of three cytokines were modestly but significantly increased in FAOD (IFNγ, IL‐8, and MDC), and plasma levels of IL‐10 (considered an inflammation‐dampening cytokine) were significantly decreased. These novel results indicate that while asymptomatic FAOD patients do not display gross body‐wide inflammation even after moderate exercise, β‐oxidation deficiencies might be associated with chronic and subtle activation of “sterile inflammation.” Further studies are warranted to determine if inflammation is more apparent in poorly controlled long‐chain FAOD or when long‐chain FAOD‐associated symptoms are present.
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Affiliation(s)
- Colin S McCoin
- Department of Molecular and Integrative Physiology, Medical Center, University of Kansas, Kansas City, Kansas
| | - Melanie B Gillingham
- Department of Molecular and Medical Genetics, Oregon Health and Science University, Portland, Oregon
| | - Trina A Knotts
- School of Medicine Department of Anatomy, Physiology and Cell Biology, University of California, Davis, School of Veterinary Medicine, Davis, California
| | - Jerry Vockley
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Michael L Blackburn
- Arkansas Children's Nutrition Center, Little Rock, Arkansas.,Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Jennifer E Norman
- Department of Internal Medicine, University of California, Davis, School of Medicine, Davis, California
| | - Sean H Adams
- Arkansas Children's Nutrition Center, Little Rock, Arkansas.,Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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9
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Ruiz M, Cuillerier A, Daneault C, Deschênes S, Frayne IR, Bouchard B, Forest A, Legault JT, Vaz FM, Rioux JD, Burelle Y, Des Rosiers C. Lipidomics unveils lipid dyshomeostasis and low circulating plasmalogens as biomarkers in a monogenic mitochondrial disorder. JCI Insight 2019; 4:123231. [PMID: 31341105 DOI: 10.1172/jci.insight.123231] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 05/31/2019] [Indexed: 12/17/2022] Open
Abstract
Mitochondrial dysfunction characterizes many rare and common age-associated diseases. The biochemical consequences, underlying clinical manifestations, and potential therapeutic targets, remain to be better understood. We tested the hypothesis that lipid dyshomeostasis in mitochondrial disorders goes beyond mitochondrial fatty acid β-oxidation, particularly in liver. This was achieved using comprehensive untargeted and targeted lipidomics in a case-control cohort of patients with Leigh syndrome French-Canadian variant (LSFC), a mitochondrial disease caused by mutations in LRPPRC, and in mice harboring liver-specific inactivation of Lrpprc (H-Lrpprc-/-). We discovered a plasma lipid signature discriminating LSFC patients from controls encompassing lower levels of plasmalogens and conjugated bile acids, which suggest perturbations in peroxisomal lipid metabolism. This premise was reinforced in H-Lrpprc-/- mice, which compared with littermates recapitulated a similar, albeit stronger peroxisomal metabolic signature in plasma and liver including elevated levels of very-long-chain acylcarnitines. These mice also presented higher transcript levels for hepatic markers of peroxisome proliferation in addition to lipid remodeling reminiscent of nonalcoholic fatty liver diseases. Our study underscores the value of lipidomics to unveil unexpected mechanisms underlying lipid dyshomeostasis ensuing from mitochondrial dysfunction herein implying peroxisomes and liver, which likely contribute to the pathophysiology of LSFC, but also other rare and common mitochondrial diseases.
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Affiliation(s)
- Matthieu Ruiz
- Department of Nutrition and.,Department of Medicine, Université de Montréal, Montreal, Quebec, Canada.,Montreal Heart Institute Research Center, Montreal, Quebec, Canada
| | - Alexanne Cuillerier
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences and Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Sonia Deschênes
- Montreal Heart Institute Research Center, Montreal, Quebec, Canada
| | | | | | - Anik Forest
- Montreal Heart Institute Research Center, Montreal, Quebec, Canada
| | | | | | - Frederic M Vaz
- Amsterdam UMC, University of Amsterdam, Laboratory Genetic Metabolic Diseases, Core Facility Metabolomics, Amsterdam Gastroenterology & Metabolism, Meibergdreef, Amsterdam, Netherlands
| | - John D Rioux
- Department of Medicine, Université de Montréal, Montreal, Quebec, Canada.,Montreal Heart Institute Research Center, Montreal, Quebec, Canada
| | - Yan Burelle
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences and Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Christine Des Rosiers
- Department of Nutrition and.,Montreal Heart Institute Research Center, Montreal, Quebec, Canada
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10
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Angelini A, Pi X, Xie L. Dioxygen and Metabolism; Dangerous Liaisons in Cardiac Function and Disease. Front Physiol 2017; 8:1044. [PMID: 29311974 PMCID: PMC5732914 DOI: 10.3389/fphys.2017.01044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 11/29/2017] [Indexed: 12/19/2022] Open
Abstract
The heart must consume a significant amount of energy to sustain its contractile activity. Although the fuel demands are huge, the stock remains very low. Thus, in order to supply its daily needs, the heart must have amazing adaptive abilities, which are dependent on dioxygen availability. However, in myriad cardiovascular diseases, “fuel” depletion and hypoxia are common features, leading cardiomyocytes to favor low-dioxygen-consuming glycolysis rather than oxidation of fatty acids. This metabolic switch makes it challenging to distinguish causes from consequences in cardiac pathologies. Finally, despite the progress achieved in the past few decades, medical treatments have not improved substantially, either. In such a situation, it seems clear that much remains to be learned about cardiac diseases. Therefore, in this review, we will discuss how reconciling dioxygen availability and cardiac metabolic adaptations may contribute to develop full and innovative strategies from bench to bedside.
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Affiliation(s)
- Aude Angelini
- Department of Medicine-Athero and Lipo, Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX, United States
| | - Xinchun Pi
- Department of Medicine-Athero and Lipo, Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX, United States
| | - Liang Xie
- Department of Medicine-Athero and Lipo, Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX, United States
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