Pyruvate dehydrogenase complex stimulation promotes immunometabolic homeostasis and sepsis survival

JCI Insight. 2018 Aug 9;3(15):e99292. doi: 10.1172/jci.insight.99292.

Abstract

Limited understanding of the mechanisms responsible for life-threatening organ and immune failure hampers scientists' ability to design sepsis treatments. Pyruvate dehydrogenase kinase 1 (PDK1) is persistently expressed in immune-tolerant monocytes of septic mice and humans and deactivates mitochondrial pyruvate dehydrogenase complex (PDC), the gate-keeping enzyme for glucose oxidation. Here, we show that targeting PDK with its prototypic inhibitor dichloroacetate (DCA) reactivates PDC; increases mitochondrial oxidative bioenergetics in isolated hepatocytes and splenocytes; promotes vascular, immune, and organ homeostasis; accelerates bacterial clearance; and increases survival. These results indicate that the PDC/PDK axis is a druggable mitochondrial target for promoting immunometabolic and organ homeostasis during sepsis.

Keywords: Glucose metabolism; Homeostasis; Immunology; Infectious disease; Mitochondria.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Cells, Cultured
  • Dichloroacetic Acid / pharmacology*
  • Dichloroacetic Acid / therapeutic use
  • Disease Models, Animal
  • Drug Evaluation, Preclinical
  • Energy Metabolism / drug effects
  • Energy Metabolism / immunology
  • Homeostasis / drug effects
  • Homeostasis / immunology
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Mice
  • Mitochondria / drug effects
  • Mitochondria / immunology
  • Mitochondria / metabolism
  • Monocytes / cytology
  • Monocytes / immunology
  • Monocytes / metabolism
  • Primary Cell Culture
  • Pyruvate Dehydrogenase Acetyl-Transferring Kinase / antagonists & inhibitors*
  • Pyruvate Dehydrogenase Acetyl-Transferring Kinase / metabolism
  • Pyruvate Dehydrogenase Complex / metabolism*
  • Sepsis / drug therapy*
  • Sepsis / immunology
  • Sepsis / mortality
  • Signal Transduction / drug effects
  • Signal Transduction / immunology
  • Treatment Outcome

Substances

  • Pyruvate Dehydrogenase Acetyl-Transferring Kinase
  • Pyruvate Dehydrogenase Complex
  • Dichloroacetic Acid