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Pey V, Stephan M, Gros P, Dray C, Bounes F, Marcheix B, Minville V, Galinier A, Labaste F. Assessment of arterial whole blood redox potential during cardiopulmonary bypass. PLoS One 2025; 20:e0324437. [PMID: 40424308 PMCID: PMC12111299 DOI: 10.1371/journal.pone.0324437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2024] [Accepted: 04/23/2025] [Indexed: 05/29/2025] Open
Abstract
INTRODUCTION Imbalance in the redox equilibrium is common in any type of aggression. Cardiopulmonary bypass (CPB) initiation induces metabolic perturbations, and reliable biological monitoring tools for this condition are currently limited (e.g., lactate/pyruvate ratio). The measurement of arterial whole blood redox potential (Eredox) provides a systemic assessment of the redox state and may serve as a valuable marker for detecting metabolic perturbations during CPB. In this prospective exploratory study involving patients undergoing cardiac surgery, we investigated variations in Eredox and lactate/pyruvate ratio during CPB initiation. METHODS Using a prospective exploratory study design, we assessed the changes in Eredox and relevant variables during the initiation of CPB in 16 cardiac surgery patients. RESULTS Upon initiation of CPB we observed a significant decrease in arterial whole blood redox potential (101.90 mV + /- 11.52 vs. 41.80 mV + /- 10,26; p < 0.0001). Concomitantly, the lactate/pyruvate ratio significantly increased (12.81 + /- 0.90 vs 67.1 + /- 7.94; p < 0.0001) while the acetoacetate/β-hydroxybutyrate ratio significantly decreased (1.11 + /- 0.19 vs. 0.54 + /- 0.05 at 0 min; p = 0.0055). The circulatory failure indicated by changes in the lactate/pyruvate ratio and ketone bodies at the initiation of CPB correlated with a significant reduction in Eredox. CONCLUSION Arterial Eredox is a novel variable that holds promise in the detection and monitoring of metabolic aggression during CPB. Its assessment during CPB initiation could provide valuable insights into the patient's circulatory status, as the Eredox appears to be more sensitive than lactate for monitoring circulatory insufficiency.
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Affiliation(s)
- Vincent Pey
- RESTORE Research Center, University Toulouse 3-Paul Sabatier, INSERM, CNRS, EFS, ENVT, Toulouse, France
- Department of Anaesthesiology and Critical Care, University Hospital of Toulouse, University Toulouse 3-Paul Sabatier,
| | - Marion Stephan
- RESTORE Research Center, University Toulouse 3-Paul Sabatier, INSERM, CNRS, EFS, ENVT, Toulouse, France
- Laboratoire de Génie Chimique, Université de Toulouse, CNRS, INPT, UPS, Toulouse, France
| | - Pierre Gros
- Laboratoire de Génie Chimique, Université de Toulouse, CNRS, INPT, UPS, Toulouse, France
| | - Cédric Dray
- RESTORE Research Center, University Toulouse 3-Paul Sabatier, INSERM, CNRS, EFS, ENVT, Toulouse, France
| | - Fanny Bounes
- Department of Anaesthesiology and Critical Care, University Hospital of Toulouse, University Toulouse 3-Paul Sabatier,
| | - Bertrand Marcheix
- Department of Cardiovascular Surgery, University Hospital Rangueil, Toulouse, France
| | - Vincent Minville
- RESTORE Research Center, University Toulouse 3-Paul Sabatier, INSERM, CNRS, EFS, ENVT, Toulouse, France
- Department of Anaesthesiology and Critical Care, University Hospital of Toulouse, University Toulouse 3-Paul Sabatier,
| | - Anne Galinier
- RESTORE Research Center, University Toulouse 3-Paul Sabatier, INSERM, CNRS, EFS, ENVT, Toulouse, France
- Department of biochemistry, Toulouse University Hospital, Toulouse, France
| | - François Labaste
- RESTORE Research Center, University Toulouse 3-Paul Sabatier, INSERM, CNRS, EFS, ENVT, Toulouse, France
- Department of Anaesthesiology and Critical Care, University Hospital of Toulouse, University Toulouse 3-Paul Sabatier,
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Shirai T, Uemichi K, Iwai R, Shinkai H, Iwata T, Tanimura R, Sugiyama S, Takemasa T. Systemic effect of combined functional overload and endurance-type swimming exercise on whole body metabolism in mice. Am J Physiol Endocrinol Metab 2025; 328:E695-E710. [PMID: 40248969 DOI: 10.1152/ajpendo.00433.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2024] [Revised: 02/06/2025] [Accepted: 03/26/2025] [Indexed: 04/19/2025]
Abstract
In this study, we examined the effects of concurrent functional overload and endurance exercise on muscle hypertrophy, mitochondrial function, and systemic adaptations in male mice. The mice were assigned to three groups: Sham (Sham), overload-induced hypertrophy (OL), and overload with concurrent 60-min free swimming (5 times/wk) (OL + Swim), for 4 wk. Although OL promoted muscle hypertrophy and protein synthesis through the Akt/mammalian/mechanistic target of rapamycin (mTOR) signaling pathway, the addition of swimming (OL + Swim) attenuated these effects, resulting in less pronounced muscle growth and a smaller increase in myofiber cross-sectional area. Notably, the OL + Swim group exhibited enhanced mitochondrial activity and glycogen content compared with the OL group. Both the OL and OL + Swim groups showed elevated rates of protein synthesis, with a significant upregulation of AMP-activated kinase (AMPK) and peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α) in the OL + Swim group, suggesting enhanced mitochondrial biogenesis and adaptation. Concurrent training also resulted in systemic benefits, including reduced inguinal and epididymal white adipocyte size, improved mitochondrial enzyme activities in adipose and liver tissues, and higher levels of fibronectin type III domain containing protein 5 (FNDC5), fibroblast growth factor 21 (FGF21), and brain-derived neurotrophic factor (BDNF) in serum, which contributed to enhanced muscle protein synthesis in cultured muscle cells. These results highlight the trade-offs between muscle hypertrophy and metabolic health in mice and underscore the importance of balanced training regimens to optimize overall metabolic health and muscle function. Our results provide further insight into how concurrent strength and endurance training can be optimized for health and performance benefits.NEW & NOTEWORTHY This study provides novel insights into the mechanisms underlying the interference effect that occurs in concurrent training, highlighting the potential systemic benefits of combining resistance and endurance exercises. Despite a reduction in muscle hypertrophy, concurrent training enhances metabolic adaptations and systemic health markers and offers a comprehensive approach to improving both muscle and metabolic fitness.
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Affiliation(s)
- Takanaga Shirai
- Department of Human Sciences, Kanagawa University, Kanagawa, Japan
- Research Fellow of Japan Society for Promotion Science, Tokyo, Japan
- Institute of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
| | - Kazuki Uemichi
- Research Fellow of Japan Society for Promotion Science, Tokyo, Japan
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
| | - Ryoto Iwai
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
| | - Hayato Shinkai
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
| | - Tomohiro Iwata
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
| | - Riku Tanimura
- Research Fellow of Japan Society for Promotion Science, Tokyo, Japan
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
| | - Shunsuke Sugiyama
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
| | - Tohru Takemasa
- Institute of Health and Sport Sciences, University of Tsukuba, Ibaraki, Japan
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Soni S, Skow RJ, Foulkes S, Haykowsky MJ, Dyck JRB. Therapeutic potential of ketone bodies on exercise intolerance in heart failure: looking beyond the heart. Cardiovasc Res 2025; 121:230-240. [PMID: 39825790 PMCID: PMC12012446 DOI: 10.1093/cvr/cvaf004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2024] [Revised: 11/13/2024] [Accepted: 12/05/2024] [Indexed: 01/20/2025] Open
Abstract
Recent evidence suggests that ketone bodies have therapeutic potential in many cardiovascular diseases including heart failure (HF). Accordingly, this has led to multiple clinical trials that use ketone esters (KEs) to treat HF patients highlighting the importance of this ketone therapy. KEs, specifically ketone monoesters, are synthetic compounds which, when consumed, are de-esterified into two β-hydroxybutyrate (βOHB) molecules and increase the circulating βOHB concentration. While many studies have primarily focused on the cardiac benefits of ketone therapy in HF, ketones can have numerous favourable effects in other organs such as the vasculature and skeletal muscle. Importantly, vascular and skeletal muscle dysfunction are also heavily implicated in the reduced exercise tolerance, the hallmark feature in HF with reduced ejection fraction and preserved ejection fraction, suggesting that some of the benefits observed in HF in response to ketone therapy may involve these non-cardiac pathways. Thus, we review the evidence suggesting how ketone therapy may be beneficial in improving cardiovascular and skeletal muscle function in HF and identify various potential mechanisms that may be important in the beneficial non-cardiac effects of ketones in HF.
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Affiliation(s)
- Shubham Soni
- Cardiovascular Research Centre, University of Alberta, Edmonton, Alberta, Canada
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Rachel J Skow
- Integrated Cardiovascular and Exercise Physiology and Rehabilitation (iCARE) Lab, Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Stephen Foulkes
- Integrated Cardiovascular and Exercise Physiology and Rehabilitation (iCARE) Lab, Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
- Heart, Exercise and Research Trials Lab, St Vincent’s Institute of Medical Research, Fitzroy, Victoria, Australia
| | - Mark J Haykowsky
- Integrated Cardiovascular and Exercise Physiology and Rehabilitation (iCARE) Lab, Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Jason R B Dyck
- Cardiovascular Research Centre, University of Alberta, Edmonton, Alberta, Canada
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
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Hørsdal OK, Larsen AM, Wethelund KL, Dalsgaard FF, Seefeldt JM, Helgestad OKL, Moeslund N, Møller JE, Ravn HB, Nielsen RR, Wiggers H, Berg-Hansen K, Gopalasingam N. The ketone body 3-hydroxybutyrate increases cardiac output and cardiac contractility in a porcine model of cardiogenic shock: a randomized, blinded, crossover trial. Basic Res Cardiol 2025:10.1007/s00395-025-01103-2. [PMID: 40220139 DOI: 10.1007/s00395-025-01103-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2025] [Revised: 03/17/2025] [Accepted: 03/19/2025] [Indexed: 04/14/2025]
Abstract
Cardiogenic shock (CS) is characterized by reduced cardiac output (CO), reduced end-organ perfusion, and high mortality. Medical therapies have failed to improve survival. The ketone body 3-hydroxybutyrate (3-OHB) enhances cardiac function in heart failure and CS. We aimed to elucidate the cardiovascular and cardiometabolic effects of 3-OHB treatment during CS. In a randomized, assessor-blinded crossover design, we studied 16 female pigs (60 kg, 5 months of age). CS was induced by left main coronary artery microsphere injections. Predefined criteria for CS were a 30% reduction in CO or mixed venous saturation (SvO2). Intravenous 3-OHB infusion and a matching control solution were administered for 120 min in random order. Hemodynamic measurements were obtained by pulmonary artery catheterization and a left ventricular (LV) pressure-volume catheter. Myocardial mitochondrial function was assessed using high resolution respirometry. During CS, infusion with 3-OHB increased CO by 0.9 L/min (95%CI 0.4-1.3 L/min) compared with control infusion. SvO2 (P = 0.026) and heart rate (P < 0.001) increased. Stroke volume (P = 0.6) was not altered. LV contractile function as determined by LV end-systolic elastance improved during 3-OHB infusion compared with control infusion (P = 0.004). Systemic and pulmonary vascular resistance decreased, and diuresis increased. LV mitochondrial function was higher after 3-OHB infusion compared with control. We conclude that 3-OHB infusion enhances cardiac function by increasing contractility and reducing vascular resistance, while also preserving myocardial mitochondrial respiratory function in a large animal model of ischemic CS. These novel findings support the therapeutic potential of exogenous ketone supplementation in CS management.
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Affiliation(s)
- Oskar Kjærgaard Hørsdal
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
- Department of Cardiology, Aarhus University Hospital, Palle Juul Jensens Boulevard 99, 8200, Aarhus N, Denmark.
| | - Alexander Møller Larsen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Frederik Flyvholm Dalsgaard
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Jacob Marthinsen Seefeldt
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Ole Kristian Lerche Helgestad
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Clinical Pharmacology, Aalborg University Hospital, Aalborg, Denmark
| | - Niels Moeslund
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Heart-, Lung-, and Vascular Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Jacob Eifer Møller
- Department of Cardiology, Heart Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Hanne Berg Ravn
- Department of Anesthesiology and Intensive Care, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Roni Ranghøj Nielsen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik Wiggers
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Kristoffer Berg-Hansen
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
| | - Nigopan Gopalasingam
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark
- Department of Cardiology, Gødstrup Hospital, Gødstrup, Denmark
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Gentili V, Schiuma G, Dilliraj LN, Beltrami S, Rizzo S, Lara D, Giovannini PP, Marti M, Bortolotti D, Trapella C, Narducci M, Rizzo R. DAG-MAG-ΒHB: A Novel Ketone Diester Modulates NLRP3 Inflammasome Activation in Microglial Cells in Response to Beta-Amyloid and Low Glucose AD-like Conditions. Nutrients 2024; 17:149. [PMID: 39796582 PMCID: PMC11722608 DOI: 10.3390/nu17010149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2024] [Revised: 12/26/2024] [Accepted: 12/28/2024] [Indexed: 01/13/2025] Open
Abstract
BACKGROUND A neuroinflammatory disease such as Alzheimer's disease, presents a significant challenge in neurotherapeutics, particularly due to the complex etiology and allostatic factors, referred to as CNS stressors, that accelerate the development and progression of the disease. These CNS stressors include cerebral hypo-glucose metabolism, hyperinsulinemia, mitochondrial dysfunction, oxidative stress, impairment of neuronal autophagy, hypoxic insults and neuroinflammation. This study aims to explore the efficacy and safety of DAG-MAG-ΒHB, a novel ketone diester, in mitigating these risk factors by sustaining therapeutic ketosis, independent of conventional metabolic pathways. METHODS We evaluated the intestinal absorption of DAG-MAG-ΒHB and the metabolic impact in human microglial cells. Utilizing the HMC3 human microglia cell line, we examined the compound's effect on cellular viability, Acetyl-CoA and ATP levels, and key metabolic enzymes under hypoglycemia. Additionally, we assessed the impact of DAG-AG-ΒHB on inflammasome activation, mitochondrial activity, ROS levels, inflammation and phagocytic rates. RESULTS DAG-MAG-ΒHB showed a high rate of intestinal absorption and no cytotoxic effect. In vitro, DAG-MAG-ΒHB enhanced cell viability, preserved morphological integrity, and maintained elevated Acetyl-CoA and ATP levels under hypoglycemic conditions. DAG-MAG-ΒHB increased the activity of BDH1 and SCOT, indicating ATP production via a ketolytic pathway. DAG-MAG-ΒHB showed remarkable resilience against low glucose condition by inhibiting NLRP3 inflammasome activation. CONCLUSIONS In summary, DAG-MAG-ΒHB emerges as a promising treatment for neuroinflammatory conditions. It enhances cellular health under varying metabolic states and exhibits neuroprotective properties against low glucose conditions. These attributes indicate its potential as an effective component in managing neuroinflammatory diseases, addressing their complex progression.
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Affiliation(s)
- Valentina Gentili
- Department of Environmental and Prevention Sciences, University of Ferrara, 44121 Ferrara, Italy; (V.G.); (G.S.); (S.B.); (S.R.); (D.L.); (D.B.); (M.N.)
| | - Giovanna Schiuma
- Department of Environmental and Prevention Sciences, University of Ferrara, 44121 Ferrara, Italy; (V.G.); (G.S.); (S.B.); (S.R.); (D.L.); (D.B.); (M.N.)
| | - Latha Nagamani Dilliraj
- Department of Chemical, Pharmaceutical, Agricultural Sciences, University of Ferrara, 44121 Ferrara, Italy; (L.N.D.); (P.P.G.); (C.T.)
| | - Silvia Beltrami
- Department of Environmental and Prevention Sciences, University of Ferrara, 44121 Ferrara, Italy; (V.G.); (G.S.); (S.B.); (S.R.); (D.L.); (D.B.); (M.N.)
| | - Sabrina Rizzo
- Department of Environmental and Prevention Sciences, University of Ferrara, 44121 Ferrara, Italy; (V.G.); (G.S.); (S.B.); (S.R.); (D.L.); (D.B.); (M.N.)
| | - Djidjell Lara
- Department of Environmental and Prevention Sciences, University of Ferrara, 44121 Ferrara, Italy; (V.G.); (G.S.); (S.B.); (S.R.); (D.L.); (D.B.); (M.N.)
| | - Pier Paolo Giovannini
- Department of Chemical, Pharmaceutical, Agricultural Sciences, University of Ferrara, 44121 Ferrara, Italy; (L.N.D.); (P.P.G.); (C.T.)
| | - Matteo Marti
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy;
| | - Daria Bortolotti
- Department of Environmental and Prevention Sciences, University of Ferrara, 44121 Ferrara, Italy; (V.G.); (G.S.); (S.B.); (S.R.); (D.L.); (D.B.); (M.N.)
| | - Claudio Trapella
- Department of Chemical, Pharmaceutical, Agricultural Sciences, University of Ferrara, 44121 Ferrara, Italy; (L.N.D.); (P.P.G.); (C.T.)
| | - Marco Narducci
- Department of Environmental and Prevention Sciences, University of Ferrara, 44121 Ferrara, Italy; (V.G.); (G.S.); (S.B.); (S.R.); (D.L.); (D.B.); (M.N.)
- Management Department, Temple University, Japan Campus, Tokyo 154-0004, Japan
| | - Roberta Rizzo
- Department of Environmental and Prevention Sciences, University of Ferrara, 44121 Ferrara, Italy; (V.G.); (G.S.); (S.B.); (S.R.); (D.L.); (D.B.); (M.N.)
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