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Metabolism

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Panose prevents acute-on-chronic liver failure by reducing bacterial infection in mice
Jiaxin Li, … , Jinjun Chen, Peng Chen
Jiaxin Li, … , Jinjun Chen, Peng Chen
Published June 6, 2025
Citation Information: J Clin Invest. 2025. https://doi.org/10.1172/JCI184653.
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Panose prevents acute-on-chronic liver failure by reducing bacterial infection in mice

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Abstract

Acute-on-chronic liver failure (ACLF) is a leading cause of global liver-related mortality. Bacterial infection, especially in patients with decompensated cirrhosis (DC), commonly triggers ACLF and is difficult to treat with antibiotics. Therefore, finding alternative strategies for preventing and managing bacterial infection is an urgent priority. Here, we observed that infected DC patients and ACLF mice exhibited lower fecal panose levels than uninfected controls. Megamonas funiformis (M. funiformis), with 4α-glucanosyltransferase (4αGT) as a key enzyme for panose production, was identified as a potential panose producer. Animal experiments demonstrated that panose efficiently reduced liver injury and extended survival in ACLF mice by mitigating bacterial infection. Further results revealed that panose enhanced resistance to bacterial infection by inhibiting oxidative stress-induced gut barrier disruption, thereby limiting bacterial dissemination. Mechanistically, panose interacted with the solute carrier family 7 member 11 (SLC7A11, also known as xCT) protein to boost antioxidant glutathione (GSH) levels in intestinal epithelial cells. These findings highlight panose's potential in preventing bacterial infection, offering a valuable insight into mitigating ACLF progression.

Authors

Jiaxin Li, Shihao Xie, Meiling Chen, Changze Hong, Yuqi Chen, Fengyuan Lyu, Niexin Tang, Tianqi Chen, Lingyan Zhao, Weihao Zou, Hongjuan Peng, Jingna Bao, Peng Gu, Bernd Schnabl, Jinjun Chen, Peng Chen

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The microRNA miR-30a blocks adipose tissue fibrosis accumulation in obesity
Pradip K. Saha, … , Samuel Klein, Sean M. Hartig
Pradip K. Saha, … , Samuel Klein, Sean M. Hartig
Published June 5, 2025
Citation Information: J Clin Invest. 2025. https://doi.org/10.1172/JCI175566.
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The microRNA miR-30a blocks adipose tissue fibrosis accumulation in obesity

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Abstract

White adipose tissue (WAT) fibrosis occurring in obesity contributes to the inflammatory and metabolic co-morbidities of insulin resistance and type 2 diabetes, yet the mechanisms involved remain poorly understood. Here, we report a role for the broadly conserved microRNA miR-30a as a regulator of WAT fibrosis and systemic glucose metabolism. Mice modified to express miR-30a at elevated levels in adipose tissues maintain insulin sensitivity coupled with reduced fatty liver disease when fed high fat diet. These effects were attributable to cell-autonomous functions of miR-30a that potently increase expression of adipocyte-specific genes. Proteomic screening revealed miR-30a limits pro-fibrotic programs in subcutaneous WAT, at least in part, by repressing PAI-1, a dominant regulator of fibrinolysis and biomarker of insulin resistance. Conversely, mouse adipocytes lacking miR-30a exhibited greater expression of fibrosis markers with disrupted cellular metabolism. Lastly, miR-30a expression negatively correlates with PAI-1 levels in subcutaneous WAT from people with obesity, further supporting an anti-fibrotic role for miR-30a. Together, these findings uncover miR-30a as a critical regulator of adipose tissue fibrosis that predicts metabolically healthy obesity in people and mice.

Authors

Pradip K. Saha, Robert Sharp, Aaron R. Cox, Rabie Habib, Michael J. Bolt, Jessica B. Felix, Claudia E. Ramirez Bustamante, Xin Li, Sung Yun Jung, Kang Ho Kim, Kai Sun, Huaizhu Wu, Samuel Klein, Sean M. Hartig

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Hepatic glycogen directly regulates gluconeogenesis through an AMPK/CRTC2 axis in mice
Bichen Zhang, … , Jeffrey E. Pessin, Alan R. Saltiel
Bichen Zhang, … , Jeffrey E. Pessin, Alan R. Saltiel
Published June 2, 2025
Citation Information: J Clin Invest. 2025;135(11):e188363. https://doi.org/10.1172/JCI188363.
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Hepatic glycogen directly regulates gluconeogenesis through an AMPK/CRTC2 axis in mice

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Glycogenolysis and gluconeogenesis ensure sufficient hepatic glucose production during energy shortages. Here, we report that hepatic glycogen levels control the phosphorylation of a transcriptional coactivator to determine the amplitude of gluconeogenesis. Decreased liver glycogen during fasting promotes gluconeogenic gene expression, while feeding-induced glycogen accumulation suppresses it. Liver-specific deletion of the glycogen scaffolding protein, protein targeting to glycogen (PTG), reduces glycogen levels, increases the expression of gluconeogenic genes, and promotes glucose production in primary hepatocytes. In contrast, liver glycogen phosphorylase (PYGL) knockdown or inhibition increases glycogen levels and represses gluconeogenic gene expression. These changes in hepatic glycogen levels are sensed by AMP-activated protein kinase (AMPK). AMPK activity is increased when glycogen levels decline, resulting in the phosphorylation and stabilization of CREB-regulated transcriptional coactivator 2 (CRTC2), which is crucial for the full activation of the cAMP-responsive transcriptional factor CREB. High glycogen allosterically inhibits AMPK, leading to CRTC2 degradation and reduced CREB transcriptional activity. Hepatocytes with low glycogen levels or high AMPK activity show higher CRTC2 protein levels, priming the cell for gluconeogenesis through transcriptional regulation. Thus, glycogen plays a regulatory role in controlling hepatic glucose metabolism through the glycogen/AMPK/CRTC2 signaling axis, safeguarding efficient glucose output during fasting and suppressing it during feeding.

Authors

Bichen Zhang, Morgan M. Johnson, Timothy Yuan, Tammy-Nhu Nguyen, Junichi Okada, Fajun Yang, Alus M. Xiaoli, Liana H. Melikian, Songran Xu, Benyamin Dadpey, Jeffrey E. Pessin, Alan R. Saltiel

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Hyperinsulinemia-induced upregulation of adipocyte TPH2 contributes to peripheral serotonin production, metabolic dysfunction, and obesity
Brian I. Park, … , Michael D. Jensen, Andrew S. Greenberg
Brian I. Park, … , Michael D. Jensen, Andrew S. Greenberg
Published June 2, 2025
Citation Information: J Clin Invest. 2025. https://doi.org/10.1172/JCI190765.
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Hyperinsulinemia-induced upregulation of adipocyte TPH2 contributes to peripheral serotonin production, metabolic dysfunction, and obesity

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Tryptophan hydroxylase (TPH) is a rate-limiting enzyme for serotonin or 5-hydroxytryptamine (5-HT) synthesis. Previously, adipocyte TPH1 has been linked to increased adipose 5-HT, reduced BAT thermogenesis, and obesity. However, the role of TPH2, a neural isoform highly expressed in obese adipose tissue, is unknown. Here, we report that adipose tissue expression of TPH2 is significantly elevated in both diet-induced obese (DIO) and ob/ob mice, as well as in obese humans. In high-fat diet (HFD)-fed mice, adipocyte TPH2 deficiency improves DIO-induced metabolic complications, enhances BAT thermogenesis, and increases intestinal energy harvesting efficiency without affecting adiposity. Conversely, TPH2 overexpression in epididymal adipocytes of chow-fed mice raises adipose and plasma 5-HT levels, suppresses BAT thermogenesis, and exacerbates obesity and metabolic dysfunction. We found that obesity-induced hyperinsulinemia upregulates adipocyte TPH2 expression via activation of mechanistic target of rapamycin complex 1 (mTORC1) and sterol regulatory element binding protein 1 (SREBP1). In humans, TPH2 mRNA levels in subcutaneous adipose tissue, but not TPH1, is positively correlated with fasting plasma insulin concentrations. In summary, our study demonstrates that obesity-associated increases in adipocyte TPH2 can regulate distal tissue physiology and energy metabolism, suggesting that TPH2 could be a potential therapeutic target for obesity and its associated complications.

Authors

Brian I. Park, Andrew R. Reeves, Ying Zhu, Robin A. Wilson, Sophia C. Fernandes, Kimberly K. Buhman, Kelli A. Lytle, Michael D. Jensen, Andrew S. Greenberg

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Trapα deficiency impairs the early events of insulin biosynthesis and glucose homeostasis
Xin Li, … , Peter Arvan, Ming Liu
Xin Li, … , Peter Arvan, Ming Liu
Published May 20, 2025
Citation Information: J Clin Invest. 2025. https://doi.org/10.1172/JCI179845.
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Trapα deficiency impairs the early events of insulin biosynthesis and glucose homeostasis

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Defects in the early events of insulin biosynthesis, including inefficient preproinsulin (PPI) translocation across the membrane of the endoplasmic reticulum (ER) and proinsulin (PI) misfolding in the ER, can cause diabetes. Cellular machineries involved in these events remain poorly defined. Gene encoding TRanslocon-Associated Protein alpha (TRAPα) shows linkage to glycemic control in humans, although their pathophysiological role remains unknown. Here we found that β-cell specific TRAPα knockout (TRAPα-βKO) mice fed with chow diet or high fat diet (HFD) exhibit decreased circulating insulin, with age- and diet-related glucose intolerance. Multiple independent approaches revealed that TRAPα-βKO not only causes inefficient PPI translocation, but also leads to PI misfolding and ER stress, selectively limiting PI ER export and β-cell compensatory potential. Importantly, decreased TRAPα expression was evident in islets of wild-type mice fed with high fat diet and in patients with type 2 diabetes (T2D). Furthermore, TRAPα expression was positively correlated with insulin content in human islet β cells, and decreased TRAPα was associated with PI maturation defects in T2D islets. Together, these data demonstrate that TRAPα deficiency in pancreatic β-cells impairs PPI translocation, PI folding, insulin production, and glucose homeostasis, contributing to its genetic linkage to T2D.

Authors

Xin Li, Jingxin Hu, Yumeng Huang, Hai Zhang, Ning Xu, Yang Liu, Xuan Liu, Yuanyuan Ye, Xinxin Zhang, Xiaoxi Xu, Yuxin Fan, Ziyue Zhang, Weiping J. Zhang, Shusen Wang, Wenli Feng, Peter Arvan, Ming Liu

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AgRP neuron hyperactivity drives hyperglycemia in a mouse model of type 2 diabetes
Yang Gou, … , Gregory J. Morton, Michael W. Schwartz
Yang Gou, … , Gregory J. Morton, Michael W. Schwartz
Published May 15, 2025
Citation Information: J Clin Invest. 2025;135(10):e189842. https://doi.org/10.1172/JCI189842.
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AgRP neuron hyperactivity drives hyperglycemia in a mouse model of type 2 diabetes

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Growing evidence suggests that the pathogenesis of type 2 diabetes (T2D) involves dysfunctional central mechanisms, and, hence, the brain can be targeted to treat this disease. As an example, a single intracerebroventricular (icv) injection of fibroblast growth factor 1 (FGF1) can normalize hyperglycemia for weeks or months in rodent models of T2D. Convergent evidence implicates inhibition of a particular subset of neurons as a mediator of this FGF1 effect. Specifically, AgRP neurons, which are located in the hypothalamic arcuate nucleus (ARC) and are hyperactive in Lepob/ob mice and other rodent models of T2D. To investigate whether chronic AgRP neuron inactivation mimics the antidiabetic action of FGF1, we directed an adeno-associated virus (AAV) containing a cre-inducible tetanus toxin–GFP (TeTx-GFP) cassette (or cre-inducible AAV GFP control) to the ARC of obese, diabetic male Lepob/ob mice in which cre recombinase is expressed solely by AgRP neurons (Lepob/ob AgRP-Cre mice). We report that over a 10-wk period of observation, hyperglycemia was fully normalized by AgRP neuron inactivation. In contrast, changes in energy homeostasis parameters (food intake, energy expenditure, body weight, and fat mass) were not observed. We conclude that in diabetic male Lepob/ob mice, AgRP neuron hyperactivity is required for hyperglycemia but is dispensable for obesity.

Authors

Yang Gou, Micaela Glat, Vincent Damian, Caeley L. Bryan, Bao Anh Phan, Chelsea L. Faber, Arikta Trivedi, Matthew K. Hwang, Jarrad M. Scarlett, Gregory J. Morton, Michael W. Schwartz

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GluN2B suppression restores phenylalanine-induced neuroplasticity and cognition impairments in a mouse model of phenylketonuria
Woo Seok Song, … , Jae Min Lim, Myoung-Hwan Kim
Woo Seok Song, … , Jae Min Lim, Myoung-Hwan Kim
Published May 8, 2025
Citation Information: J Clin Invest. 2025. https://doi.org/10.1172/JCI184299.
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GluN2B suppression restores phenylalanine-induced neuroplasticity and cognition impairments in a mouse model of phenylketonuria

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Phenylketonuria (PKU), an inborn error of phenylalanine (Phe) metabolism, is a common cause of intellectual disability. However, the mechanisms by which elevated phenylalanine (Phe) levels cause cognitive impairment remain unclear. Here, we show that submillimolar Phe perturbs synaptic plasticity through the hyperactivation of GluN2B-containing NMDARs. PahEnu2 PKU model mice exhibited submillimolar and supramillimolar concentrations of Phe in the cerebrospinal fluid (CSF) and serum, respectively. L-Phe produced concentration-dependent bidirectional effects on NMDA-induced currents, without affecting synaptic NMDARs in hippocampal CA1 neurons. L-Phe-induced hyperactivation of extrasynaptic GluN2B resulted in activity-dependent downregulation of AMPARs during burst or sustained synaptic activity. Administration of L-Phe in mice decreased neural activity and impaired memory, which were blocked by pretreatment with GluN2B inhibitors. Furthermore, pharmacological and virus-mediated suppression of GluN2B reversed the impaired learning in PahEnu2 mice. Collectively, these results suggest that the concentration of Phe in the CSF of patients with PKU perturbs extrasynaptic NMDARs and synaptic plasticity, and that suppression of GluN2B may have the potential to improve cognitive function in patients with PKU.

Authors

Woo Seok Song, Young Sook Kim, Young-Soo Bae, Sang Ho Yoon, Jae Min Lim, Myoung-Hwan Kim

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Weight loss in MASLD restores the balance of liver fatty acid sources
Jennifer E. Lambert, … , Thomas Rogers, Elizabeth J. Parks
Jennifer E. Lambert, … , Thomas Rogers, Elizabeth J. Parks
Published May 1, 2025
Citation Information: J Clin Invest. 2025;135(9):e174233. https://doi.org/10.1172/JCI174233.
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Weight loss in MASLD restores the balance of liver fatty acid sources

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BACKGROUND Lipogenesis contributes substantially to the pathological accumulation of intrahepatic triacylglycerol (IHTG) in metabolic dysfunction–associated steatotic liver disease (MASLD). Since hepatic lipogenesis is highly sensitive to energy intake, we hypothesized that mechanisms of MASLD regression induced by weight loss would be driven by a marked reduction in the lipogenic pathway.METHODS Overweight adults with high liver fat (HighLF; n = 9; IHTG ≥ 5.6% measured by 1H-magnetic resonance spectroscopy) or low (normal) liver fat (LowLF; n = 6; IHTG < 5.6%) received dietary counseling for 6 months and underwent comprehensive metabolic phenotyping during inpatient studies that captured fasting and fed states. Multiple stable isotopes were used to assess the contribution of lipogenesis, free fatty acids (FFAs), and dietary fat to IHTG.RESULTS Body weight loss (–10% ± 2%) reduced IHTG in individuals with MASLD (19.4% ± 3.6% to 4.5% ± 2.1%, P < 0.001). Insulin sensitivity improved significantly (46%, P < 0.01), while fasting FFA flux from adipose tissue was not different. VLDL-triacylglycerol (VLDL-TG) concentrations fell by 38% (P = 0.02) because of a 67% reduction in contribution from lipogenesis (P = 0.02), whereas the absolute contributions from FFAs and dietary fat to VLDL-TG were not different. Reduced lipogenesis was significantly associated with loss of IHTG.CONCLUSION These data underscore the primary role of lipogenesis in MASLD pathology and highlight the importance of controlling this pathway through treatment strategies.TRIAL REGISTRATION ClinicalTrials.gov (NCT01371396).FUNDING National Institutes of Health (NIH) grant RL1DK081187; Task Force for Obesity Research at Southwestern (TORS) NIH UL1DE019584; and Clinical and Translational Science Award NIH/National Center for Advancing Translational Sciences UL1-RR024982.

Authors

Jennifer E. Lambert, Maria A. Ramos-Roman, Maressa J. Valdez, Jeffrey D. Browning, Thomas Rogers, Elizabeth J. Parks

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Ketogenesis mitigates metabolic dysfunction-associated steatotic liver disease through mechanisms that extend beyond fat oxidation
Eric D. Queathem, … , Patrycja Puchalska, Peter A. Crawford
Eric D. Queathem, … , Patrycja Puchalska, Peter A. Crawford
Published April 24, 2025
Citation Information: J Clin Invest. 2025. https://doi.org/10.1172/JCI191021.
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Ketogenesis mitigates metabolic dysfunction-associated steatotic liver disease through mechanisms that extend beyond fat oxidation

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The progression of metabolic dysfunction-associated steatotic liver disease (MASLD) to metabolic dysfunction-associated steatohepatitis (MASH) involves alterations in both liver-autonomous and systemic metabolism that influence the liver’s balance of fat accretion and disposal. Here, we quantify the contributions of hepatic oxidative pathways to liver injury in MASLD-MASH. Using NMR spectroscopy, UHPLC-MS, and GC-MS, we performed stable-isotope tracing and formal flux modeling to quantify hepatic oxidative fluxes in humans across the spectrum of MASLD-MASH, and in mouse models of impaired ketogenesis. In humans with MASH, liver injury correlated positively with ketogenesis and total fat oxidation, but not with turnover of the tricarboxylic acid cycle. Loss-of-function mouse models demonstrated that disruption of mitochondrial HMG-CoA synthase (HMGCS2), the rate-limiting step of ketogenesis, impairs overall hepatic fat oxidation and induces a MASLD-MASH-like phenotype. Disruption of mitochondrial β-hydroxybutyrate dehydrogenase (BDH1), the terminal step of ketogenesis, also impaired fat oxidation, but surprisingly did not exacerbate steatotic liver injury. Taken together, these findings suggest that quantifiable variations in overall hepatic fat oxidation may not be a primary determinant of MASLD-to-MASH progression, but rather, that maintenance of ketogenesis could serve a protective role through additional mechanisms that extend beyond overall rates of fat oxidation.

Authors

Eric D. Queathem, David B. Stagg, Alisa B. Nelson, Alec B. Chaves, Scott B. Crown, Kyle Fulghum, D. Andre d'Avignon, Justin R. Ryder, Patrick J. Bolan, Abdirahman Hayir, Jacob R. Gillingham, Shannon Jannatpour, Ferrol I. Rome, Ashley S. Williams, Deborah M. Muoio, Sayeed Ikramuddin, Curtis C. Hughey, Patrycja Puchalska, Peter A. Crawford

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Plasma endotrophin levels correlate with insulin resistance in people with obesity
Gordon I. Smith, Samuel Klein
Gordon I. Smith, Samuel Klein
Published April 22, 2025
Citation Information: J Clin Invest. 2025. https://doi.org/10.1172/JCI190577.
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Plasma endotrophin levels correlate with insulin resistance in people with obesity

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BACKGROUND. Adipose tissue-derived endotrophin, a peptide cleaved from the α3 chain of collagen VI during fibrogenesis, causes systemic insulin resistance in rodent models. Here, we evaluated the potential importance of endotrophin in regulating whole-body insulin sensitivity in people. METHODS. We evaluated: i) plasma endotrophin concentration, insulin sensitivity (assessed by using the hyperinsulinemic-euglycemic clamp procedure in conjunction with stable isotopically labeled glucose tracer infusion) and adipose tissue expression of genes involved in endotrophin production in three groups of participants that were rigorously stratified by adiposity and insulin sensitivity [lean insulin-sensitive (Lean-IS; n=10), obese insulin-sensitive (Obese-IS; n=10), and obesity insulin-resistant (Obese-IR; n=10)]; ii) plasma endotrophin concentration and insulin sensitivity in 15 people with obesity and type 2 diabetes before and after marked (~18%) weight loss; and iii) the effect of endotrophin on insulin signaling (AKTser473 phosporylation) and insulin action (insulin-stimulated glucose uptake) in primary human skeletal muscle myotubes. RESULTS. Plasma endotrophin progressively increased from the Lean-IS to the Obese-IS to the Obese-IR group, was negatively associated with insulin sensitivity and positively associated with factors involved in adipose tissue endotrophin production, namely adipose tissue gene expression of matrix metalloproteinases and markers of hypoxia, inflammation, and fibrosis. Marked weight loss increased insulin sensitivity in conjunction with a decrease in plasma endotrophin concentration. Endotrophin inhibited insulin insulin-stimulated AKTser473 phosphorylation and insulin-stimulated glucose uptake in myotubes, which was restored by incubation with a neutralizing endotrophin antibody. CONCLUSIONS. These results suggest plasma endotrophin is both a biomarker and cause of whole-body insulin resistance in people with obesity.

Authors

Gordon I. Smith, Samuel Klein

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Using SORLA to sort out human obesity
Vanessa Schmidt and colleagues demonstrate that the intracellular sorting receptor SORLA is an important regulator of lipid metabolism…
Published June 20, 2016
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Intracellular calcium leak recasts β cell landscape
Gaetano Santulli and colleagues reveal that RyR2 calcium channels in pancreatic β cells mediate insulin release and glucose homeostasis…
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