Our work in the area of mitochondrial function, energy homeostasis and metabolomics has led us to discover a remarkably strong association between adverse cardiometabolic outcomes and tissue/blood levels of acylcarnitine (AC) conjugates. These metabolites derive from acyl-CoA intermediates of fuel catabolism and permit mitochondrial export of excess carbons. For the past decade, our laboratory has remained keenly committed to answering a crucial question: What is this AC signature telling us about the interplay between mitochondria and metabolic disease? The current proposal aims to test the hypothesis that AC accumulation reflects a bottleneck in the fatty acid oxidation (FAO) pathway that diminishes mitochondrial power and efficiency. This prediction stems from unique insights gained via the application of a new mitochondrial diagnostics platform developed by our laboratory during the previous grant cycle. In simple terms, our assays serve as an in vitro ?stress test? that evaluates how well a given population of mitochondria, fueled by specific mixtures of carbon substrates, responds to a graded energetic challenge. We have been combining this platform with mass spectrometry-based metabolomics, proteomics and 13C metabolic flux analysis to evaluate mitochondrial remodeling and corresponding changes in respiratory power and efficiency in response to a variety of nutritional and genetic maneuvers. New and exciting findings suggest that AC accumulation reflects a critical thermodynamic vulnerability in the mitochondrial FAO pathway, and thereby serves as a signal of bioenergetic stress, en route to compromised bioenergetics and impending tissue/organ failure. Moreover, our preliminary studies suggest mitochondria resident in untrained skeletal muscles and failing hearts are especially vulnerable to this lipid-induced ?traffic jam?; and that ketones are uniquely able to circumvent the roadblock to defend cellular energetics in settings of metabolic stress. Accordingly, we also aim to test the hypothesis that ketone oxidation plays an essential role in permitting the salutary mitochondrial and metabolic adaptations known to occur in response to regimens of intermittent fasting.

Public Health Relevance

Obesity, diabetes and closely related metabolic disorders are associated with impaired energy metabolism and damage to intracellular engines known as mitochondria. Dysfunction of these engines can contribute to elevated blood sugar levels, heart failure and impaired exercise tolerance. This project aims to understand how nutrient excess causes damage to skeletal muscle and heart mitochondria. We are studying processes responsible for maintaining mitochondrial health and seek to develop new therapeutic strategies to defend against mitochondrial dysfunction is the context of aging and metabolic disease.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project (R01)
Project #
5R01DK089312-10
Application #
9937824
Study Section
Integrative Physiology of Obesity and Diabetes Study Section (IPOD)
Program Officer
Laughlin, Maren R
Project Start
2010-07-01
Project End
2023-05-31
Budget Start
2020-06-01
Budget End
2021-05-31
Support Year
10
Fiscal Year
2020
Total Cost
Indirect Cost
Name
Duke University
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
044387793
City
Durham
State
NC
Country
United States
Zip Code
27705
Fisher-Wellman, Kelsey H; Davidson, Michael T; Narowski, Tara M et al. (2018) Mitochondrial Diagnostics: A Multiplexed Assay Platform for Comprehensive Assessment of Mitochondrial Energy Fluxes. Cell Rep 24:3593-3606.e10
Stöckli, Jacqueline; Fisher-Wellman, Kelsey H; Chaudhuri, Rima et al. (2017) Metabolomic analysis of insulin resistance across different mouse strains and diets. J Biol Chem 292:19135-19145
Krycer, James R; Fisher-Wellman, Kelsey H; Fazakerley, Daniel J et al. (2017) Bicarbonate alters cellular responses in respiration assays. Biochem Biophys Res Commun 489:399-403
Huffman, Kim M; Jessee, Ryan; Andonian, Brian et al. (2017) Molecular alterations in skeletal muscle in rheumatoid arthritis are related to disease activity, physical inactivity, and disability. Arthritis Res Ther 19:12
Muoio, Deborah M (2017) HDAC3 sets the timer on muscle fuel switching. Nat Med 23:148-150
Anderson, Kristin A; Huynh, Frank K; Fisher-Wellman, Kelsey et al. (2017) SIRT4 Is a Lysine Deacylase that Controls Leucine Metabolism and Insulin Secretion. Cell Metab 25:838-855.e15
Davies, Michael N; Kjalarsdottir, Lilja; Thompson, J Will et al. (2016) The Acetyl Group Buffering Action of Carnitine Acetyltransferase Offsets Macronutrient-Induced Lysine Acetylation of Mitochondrial Proteins. Cell Rep 14:243-54
Crown, Scott B; Kelleher, Joanne K; Rouf, Rosanne et al. (2016) Comprehensive metabolic modeling of multiple 13C-isotopomer data sets to study metabolism in perfused working hearts. Am J Physiol Heart Circ Physiol 311:H881-H891
Consitt, Leslie A; Koves, Timothy R; Muoio, Deborah M et al. (2016) Plasma acylcarnitines during insulin stimulation in humans are reflective of age-related metabolic dysfunction. Biochem Biophys Res Commun 479:868-874
Kien, C Lawrence; Matthews, Dwight E; Poynter, Matthew E et al. (2015) Increased palmitate intake: higher acylcarnitine concentrations without impaired progression of ?-oxidation. J Lipid Res 56:1795-807

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