L-carnitine: Searching for New Therapeutic Strategy for Sepsis Management

2021 ◽  
Vol 28 ◽  
Author(s):  
Adeleh Sahebnasagh ◽  
Razieh Avan ◽  
Mahila Monajati ◽  
Javad Hashemi ◽  
Solomon Habtemariam ◽  
...  

: In this review, we discussed the biological targets of carnitine, its effects on immune function, and how L-carnitine supplementation may help critically ill patients. L-carnitine is a potent antioxidant. L-carnitine depletion has been observed in prolonged intensive care unit (ICU) stays, while L-carnitine supplementation has beneficial effects in health promotion and regulation of immunity. It is essential for the uptake of fatty acids into mitochondria. By inhibiting the ubiquitin-proteasome system, down-regulation of apelin receptor in cardiac tissue, and reducing β-oxidation of fatty acid, carnitine may decrease vasopressor requirement in septic shock and improve clinical outcomes of this group of patients. We also have an overview of animal and clinical studies that have been recruited for evaluating the beneficial effects of L-carnitine in the management of sepsis/ septic shock. Additional clinical data are required to evaluate the optimal daily dose and duration of L-carnitine supplementation.

2018 ◽  
Vol 125 (2) ◽  
pp. 287-303 ◽  
Author(s):  
Esther Barreiro ◽  
Ester Puig-Vilanova ◽  
Anna Salazar-Degracia ◽  
Sergi Pascual-Guardia ◽  
Carme Casadevall ◽  
...  

Peripheral muscle weakness and mass loss are characteristic features in severe chronic obstructive pulmonary disease (COPD). We hypothesized that the phosphodiesterase (PDE)-4 inhibitor roflumilast-induced cAMP may ameliorate proteolysis and metabolism in skeletal muscles of COPD patients with severe muscle wasting. In myogenic precursor cells (isolated from muscle biopsies and cultured up to obtain differentiated myotubes) from 10 severe COPD patients and 10 healthy controls, which were treated with 1 μM roflumilast N-oxide (RNO) for three time cohorts (1, 6, and 24 h), genes of antioxidant defense and oxidative stress marker, myogenesis and muscle metabolism, proteolysis (tyrosine release assay) and ubiquitin-proteasome system markers, autophagy, and myosin isoforms were analyzed using RT-PCR and immunoblotting. In COPD patients at 6 h RNO treatment, myotube tyrosine release, total protein ubiquitination, and tripartite motif-containing protein 32 levels were significantly lower than healthy controls, whereas at 24 h RNO treatment, myotube myosin heavy chain ( MyHC) -I and MyHC-IIx expression levels were upregulated in both patients and controls. In the 6-h RNO cohort, in patients and controls, myotube expression of nuclear factor (erythroid-derived 2)-like 2 ( NRF2) and its downstream antioxidants sirtuin-1, FGF-inducible 14, and insulin-like growth factor-1 was upregulated, whereas that of myocyte-specific enhancer factor 2C, myogenic differentiation, myogenin, myostatin, atrogin-1, and muscle RING-finger protein-1 was downregulated. In myotubes of severe COPD patients with cachexia, roflumilast-induced cAMP signaling exerts beneficial effects by targeting muscle protein breakdown (tyrosine release), along with reduced expression of proteolytic markers of the ubiquitin-proteasome system and that of myostatin. In both patients and controls, roflumilast also favored antioxidant defense through upregulation of the NRF2 pathway and that of the histone deacetylase sirtuin-1, whereas it improved the expression of slow- and fast-twitch myosin isoforms. These findings show that muscle dysfunction and wasting may be targeted by roflumilast-induced cAMP signaling in COPD. These results have potential therapeutic implications, as this PDE-4 inhibitor is currently available for the treatment of systemic inflammation and exacerbations in patients with severe COPD. NEW & NOTEWORTHY In myotubes of cachectic chronic obstructive pulmonary disease (COPD) patients, cAMP signaling exerted beneficial effects by targeting muscle proteolysis and reducing gene expression of proteolytic markers of the ubiquitin-proteasome system and that of myostatin. In myotubes of patients and controls, roflumilast also favored antioxidant defense through upregulation of the nuclear factor (erythroid-derived 2)-like 2 pathway, of sirtuin-1, and of gene expression of slow- and fast-twitch isoforms. These findings have potential clinical implications for the treatment of muscle wasting in patients with COPD and cachexia.


2013 ◽  
Vol 3 (10) ◽  
pp. 400 ◽  
Author(s):  
Kohta Ohnishi ◽  
Kazuhiro Irie ◽  
Akira Murakami

Background: Phytochemicals are secondary metabolites of plants that are produced for their defense against environmental stresses, such as polyphenols, which are considered to play a major role in protection against ultraviolet (UV) light-induced oxidative damage, as well as anti-fungal and anti-microbial activities. In addition, there is a great body of evidence showing that phytochemicals exhibit a wide array of physiological activities in humans. Accumulated data show that the bioavailability of most, if not all, phytochemicals is quite poor and their substantial biotransformation after ingestion has also been noted. Thus, they are characterized as non-nutritive xenobiotics in animals, and the question of why phytochemicals, which are produced for plant self-defense, have beneficial effects in humans is quite intriguing. Meanwhile, stress-induced denaturing of cellular proteins greatly affects their tertiary structure and critically disrupts their biological functions, occasionally leading to aggregation for the onset of some pathology. Many recent studies have indicated that protein quality control (PQC) systems play key roles in counteracting ‘proteo-stress’, which is comprised of several processes, including protein refolding by heat shock proteins (HSPs) and degradation of abnormal proteins by the ubiquitin-proteasome system as well as autophagy.Objective: Phytochemicals are xenobiotics, thus their biochemical interactions with animal proteins are considered to occur in a non-specific manner, which raises the possibility that some phytochemicals cause proteo-stress for activating PQC systems. Because their status is thought to be a critical determinant of homeostasis, the physiological functions of phytochemicals may be partially mediated through those unique systems. The present study was thus undertaken to address this possibility. Methods and Results: We focused on zerumbone (ZER), an electrophilic sesquiterpene present in Zingiber zerumbet Smith (shampoo ginger). This agent has been reported to exhibit various bioactivities, including anti-inflammation and cancer prevention[1,2]. Treatment of Hepa1c1c7 mouse hepatoma cells with ZER resulted in marked up-regulation of multiple HSPs, such as HSP40 and HSP70. Furthermore, oral administration to the nematode Caenorhabditis elegans and SD rats increased the expressions of some HSPs[3]. Interestingly, ZER also increased proteasome activity in Hepa1c1c7 cells, which was accompanied with up-regulation of 5, a major proteasome functional protein. In addition, the agent notably up-regulated the expressions of several pro-autophagic markers, including p62 and microtubule-associated protein 1 light-chain 3 (LC3)-II[4]. Experiments with biotin-labeled ZER as well as a specific antibody against ZER-adduct proteins revealed that it binds numerous cellular proteins in a non-specific manner. Along a similar line, incubation with ZER led to formations of p62-conjugated proteins and aggresomes. Together, these results suggest that ZER causes proteo-stress for potentiating the integrity of PQC systems. In support of this notion, ZER-bound proteins have been suggested to be partially recognized by HSP90, leading to dissociation of heat shok factor 1 (HSF1) from HSP90 for inducing multiple HSP genes. Next we speculated that mild chemical stress by ZER may exert beneficial effects, since ZER-bound proteins were time-dependently degraded, suggesting that defense capacity was amplified to a great level as compared with the non-treated condition. As expected, ZER conferred thermoresistance to Caenorhabditis elegans (C. elegans) and suppressed the proteo-toxicity of 4-hydroxy-2-nonenal, a potent electrophile produced through a lipid peroxidation process, in a p62-dependent manner. We then screened a number of nutrients and phytochemicals for their HSP70 inducibility, and found that certain phytochemicals, such as curcumin, phenethyl isothiocyanate, ursolic acid, and lycopene, were significantly active, whereas most nutrients were virtually inactive. These results may be associated with the fact that phytochemicals, but not nutrients, are foreign chemicals to animals, as noted above.Conclusion: Up-regulation of antioxidant and xenobiotics metabolizing enzymes has been reported to be an adaptive response in animals exposed to phytochemicals. Our present results imply that the process also increases the capacity to counteract proteo-stresses through activation of PQC systems. This putative phenomenon, representing the concept of hormesis[5], may be associated with mechanisms underlying the physiological functions of phytochemicals. Therefore, chronic ingestion of this class of chemicals may result in ‘chemical training’, in which self-defense systems are continuously activated for adaptation to phytochemical-driven stresses.Key words: heat shock proteins, ubiquitin-proteasome system, autophagy, C. elegans


Cells ◽  
2020 ◽  
Vol 9 (10) ◽  
pp. 2284
Author(s):  
Jinkyung Cho ◽  
Youngju Choi ◽  
Pavol Sajgalik ◽  
Mi-Hyun No ◽  
Sang-Hyun Lee ◽  
...  

Sarcopenia, a syndrome commonly seen in elderly populations, is often characterized by a gradual loss of skeletal muscle, leading to the decline of muscle strength and physical performance. Growing evidence suggests that the prevalence of sarcopenia increases in patients with heart failure (HF), which is a dominant pathogenesis in the aging heart. HF causes diverse metabolic complications that may result in sarcopenia. Therefore, sarcopenia may act as a strong predictor of frailty, disability, and mortality associated with HF. Currently, standard treatments for slowing muscle loss in patients with HF are not available. Therefore, here, we review the pathophysiological mechanisms underlying sarcopenia in HF as well as current knowledge regarding the beneficial effects of exercise on sarcopenia in HF and related mechanisms, including hormonal changes, myostatin, oxidative stress, inflammation, apoptosis, autophagy, the ubiquitin-proteasome system, and insulin resistance.


2014 ◽  
Vol 111 (9) ◽  
pp. 1536-1548 ◽  
Author(s):  
Dong-Tao Wang ◽  
Lu Lu ◽  
Ying Shi ◽  
Zhen-Bo Geng ◽  
Yi Yin ◽  
...  

Ketoacids (KA) are known to improve muscle mass among patients with chronic kidney disease (CKD) on a low-protein diet (CKD-LPD), but the mechanism of its preventive effects on muscle atrophy still remains unclear. Since muscle atrophy in CKD may be attributable to the down-regulation of the Wnt7a/Akt/p70S6K pathway and the activation of the ubiquitin–proteasome system (UPS) and the apoptotic signalling pathway, a hypothesis can readily be drawn that KA supplementation improves muscle mass by up-regulating the Wnt7a/Akt/p70S6K pathway and counteracting the activation of the UPS and caspase-3-dependent apoptosis in the muscle of CKD-LPD rats. Rats with 5/6 nephrectomy were randomly divided into three groups, and fed with either 22 % protein (normal-protein diet; NPD), 6 % protein (LPD) or 5 % protein plus 1 % KA for 24 weeks. Sham-operated rats with NPD intake were used as the control. The results demonstrated that KA supplementation improved protein synthesis and increased related mediators such as Wnt7a, phosphorylated Akt and p70S6K in the muscle of CKD-LPD rats. It also inhibited protein degradation, withheld the increase in ubiquitin and its ligases MAFbx (muscle atrophy F-box) and MuRF1 (muscle ring finger-1) as well as attenuated proteasome activity in the muscle of CKD-LPD rats. Moreover, KA supplementation gave rise to a reduction in DNA fragment, cleaved caspase-3 and 14 kDa actin fragment via the down-regulation of the Bax:Bcl-2 ratio in the muscle of CKD-LPD rats. The beneficial effects unveiled herein further consolidate that KA may be a better therapeutic strategy for muscle atrophy in CKD-LPD.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kyung-Duk Min ◽  
Masanori Asakura ◽  
Manabu Shirai ◽  
Satoru Yamazaki ◽  
Shin Ito ◽  
...  

AbstractCardiogenesis requires the orchestrated spatiotemporal tuning of BMP signalling upon the balance between induction and counter-acting suppression of the differentiation of the cardiac tissue. SMADs are key intracellular transducers and the selective degradation of SMADs by the ubiquitin–proteasome system is pivotal in the spatiotemporal tuning of BMP signalling. However, among three SMADs for BMP signalling, SMAD1/5/9, only the specific E3 ligase of SMAD9 remains poorly investigated. Here, we report for the first time that SMAD9, but not the other SMADs, is ubiquitylated by the E3 ligase ASB2 and targeted for proteasomal degradation. ASB2, as well as Smad9, is conserved among vertebrates. ASB2 expression was specific to the cardiac region from the very early stage of cardiac differentiation in embryogenesis of mouse. Knockdown of Asb2 in zebrafish resulted in a thinned ventricular wall and dilated ventricle, which were rescued by simultaneous knockdown of Smad9. Abundant Smad9 protein leads to dysregulated cardiac differentiation through a mechanism involving Tbx2, and the BMP signal conducted by Smad9 was downregulated under quantitative suppression of Smad9 by Asb2. Our findings demonstrate that ASB2 is the E3 ligase of SMAD9 and plays a pivotal role in cardiogenesis through regulating BMP signalling.


2005 ◽  
Vol 41 ◽  
pp. 173-186 ◽  
Author(s):  
Didier Attaix ◽  
Sophie Ventadour ◽  
Audrey Codran ◽  
Daniel Béchet ◽  
Daniel Taillandier ◽  
...  

The ubiquitin–proteasome system (UPS) is believed to degrade the major contractile skeletal muscle proteins and plays a major role in muscle wasting. Different and multiple events in the ubiquitination, deubiquitination and proteolytic machineries are responsible for the activation of the system and subsequent muscle wasting. However, other proteolytic enzymes act upstream (possibly m-calpain, cathepsin L, and/or caspase 3) and downstream (tripeptidyl-peptidase II and aminopeptidases) of the UPS, for the complete breakdown of the myofibrillar proteins into free amino acids. Recent studies have identified a few critical proteins that seem necessary for muscle wasting {i.e. the MAFbx (muscle atrophy F-box protein, also called atrogin-1) and MuRF-1 [muscle-specific RING (really interesting new gene) finger 1] ubiquitin–protein ligases}. The characterization of their signalling pathways is leading to new pharmacological approaches that can be useful to block or partially prevent muscle wasting in human patients.


2005 ◽  
Vol 41 (1) ◽  
pp. 173 ◽  
Author(s):  
Didier Attaix ◽  
Sophie Ventadour ◽  
Audrey Codran ◽  
Daniel Béchet ◽  
Daniel Taillandier ◽  
...  

2020 ◽  
Author(s):  
Jon Uranga ◽  
Lukas Hasecke ◽  
Jonny Proppe ◽  
Jan Fingerhut ◽  
Ricardo A. Mata

The 20S Proteasome is a macromolecule responsible for the chemical step in the ubiquitin-proteasome system of degrading unnecessary and unused proteins of the cell. It plays a central role both in the rapid growth of cancer cells as well as in viral infection cycles. Herein, we present a computational study of the acid-base equilibria in an active site of the human proteasome, an aspect which is often neglected despite the crucial role protons play in the catalysis. As example substrates, we take the inhibition by epoxy and boronic acid containing warheads. We have combined cluster quantum mechanical calculations, replica exchange molecular dynamics and Bayesian optimization of non-bonded potential terms in the inhibitors. In relation to the latter, we propose an easily scalable approach to the reevaluation of non-bonded potentials making use of QM/MM dynamics information. Our results show that coupled acid-base equilibria need to be considered when modeling the inhibition mechanism. The coupling between a neighboring lysine and the reacting threonine is not affected by the presence of the inhibitor.


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