Macrophages are innate immune cells that execute a variety of functions including microbial clearance, antigen presentation, and tissue repair. When exposed to the cytokine interleukin 4 (IL-4), these cells express genes associated with alternative activation. Previous work had shown that etomoxir-mediated disruption of coenzyme A homeostasis decreases the macrophage IL-4 response, while exogenous addition of CoA enhances the presence IL-4-associated cell-surface markers. However, the mechanism by which etomoxir decreased intracellular CoA levels and how this ubiquitous metabolic cofactor could instruct alternative activation was entirely unclear. In this work, I show that etomoxir likely decreases intracellular CoA levels by thioester-mediated pantothenate kinase inhibition. Further, I demonstrate that exogenous CoA enhances the IL-4 response in vitro and in vivo. I determined that CoA acts as a weak toll-like receptor 4 agonist, which enhances the IL-4 response through activation of the MyD88 signaling cascade. Finally, I show that activation of the MyD88 pathway is sufficient to enhance alternative activation both in vitro and in vivo.
Elevated levels of BCAAs have been associated with heart failure and metabolic disease. The branched-chain ketoacid dehydrogenase kinase (BCKDK) inhibitor BT2 (3,6-dichlorobenzo[b]thiophene-2-carboxylic acid) was designed to induce branched-chain amino acid (BCAA) oxidation to restore levels of BCAAs. BT2 treatment confers cardioprotection and protects from metabolic disease in preclinical models including mice subjected to trans-aortic constriction or LAD ligation, db/db mice, ob/ob mice, and Zucker fatty rats. However, mice with the BCKDK knocked out specifically in the heart or skeletal muscle does not protect from heart failure, suggesting an alternative molecular mechanism by which BT2 is conferring its protective effects. In this study, we provide evidence characterizing BT2 as a mitochondrial uncoupler. Using reductionist systems including respirometry, mitochondrial membrane potential, and patch-clamp electrophysiology, we demonstrate that BT2 is indeed uncoupling mitochondria and is approximately five-fold milder than the well-known chemical uncoupler DNP. Functional assays expose BT2’s protective effects originate from diminishing ROS production and reducing de novo lipogenesis. The evidence provided here more likely solves the long-standing question on BT2’s mechanism by which it is conferring therapeutic effects. Furthermore, these studies establish mild uncouplers of mitochondria as promising pharmacological agents for the treatment of cardiovascular and metabolic disease.
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