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Energy metabolism in health and diseases

Energy metabolism is indispensable for sustaining physiological functions in living organisms and assumes a pivotal role across physiological and pathological conditions. This review provides an extensive overview of advancements in energy metabolism research, elucidating critical pathways such as glycolysis, oxidative phosphorylation, fatty acid metabolism, and amino acid metabolism, along with their intricate regulatory mechanisms. The homeostatic balance of these processes is crucial; however, in pathological states such as neurodegenerative diseases, autoimmune disorders, and cancer, extensive metabolic reprogramming occurs, resulting in impaired glucose metabolism and mitochondrial dysfunction, which accelerate disease progression. Recent investigations into key regulatory pathways, including mechanistic target of rapamycin, sirtuins, and adenosine monophosphate-activated protein kinase, have considerably deepened our understanding of metabolic dysregulation and opened new avenues for therapeutic innovation. Emerging technologies, such as fluorescent probes, nano-biomaterials, and metabolomic analyses, promise substantial improvements in diagnostic precision. This review critically examines recent advancements and ongoing challenges in metabolism research, emphasizing its potential for precision diagnostics and personalized therapeutic interventions. Future studies should prioritize unraveling the regulatory mechanisms of energy metabolism and the dynamics of intercellular energy interactions. Integrating cutting-edge gene-editing technologies and multi-omics approaches, the development of multi-target pharmaceuticals in synergy with existing therapies such as immunotherapy and dietary interventions could enhance therapeutic efficacy. Personalized metabolic analysis is indispensable for crafting tailored treatment protocols, ultimately providing more accurate medical solutions for patients. This review aims to deepen the understanding and improve the application of energy metabolism to drive innovative diagnostic and therapeutic strategies.

A decrease in Flavonifractor plautii and its product, phytosphingosine, predisposes individuals with phlegm-dampness constitution to metabolic disorders

According to traditional Chinese medicine (TCM) constitutional theory, individuals with phlegm-dampness constitution (PDC) are at increased risk for metabolic disorders. Previous studies have indicated that PDC individuals exhibit gene expression changes associated with metabolic disorders, even individuals with normal metabolic indices. However, the biological mechanisms underlying these changes remain unclear. The gut microbiota has recently emerged as a promising avenue for elucidating TCM principles. Here, we revealed that individuals with PDC have distinct gut microbiota and serum metabolite profiles. A decrease in phytosphingosine was associated with increased PDC scores and metabolic disorder severity. Subsequent experiments demonstrated that Flavonifractor plautii can biosynthesize phytosphingosine, which was also negatively correlated with the PDC score. Interestingly, both F. plautii and phytosphingosine levels decreased in PDC subjects with normal metabolic indices. Fecal transplantation from these individuals accelerated the development of metabolic disorders in mice. However, supplementation with F. plautii and phytosphingosine ameliorated metabolic disorders by increasing phytosphingosine levels in the gut‒hepatic axis. Mechanistic investigations confirmed that phytosphingosine can directly bind to hepatic peroxisome proliferator-activated receptor α (PPARα) and activate its nuclear transcription activity, thereby regulating downstream gene expression related to glucose‒lipid metabolism. Our research indicates that the decrease in F. plautii and its product, phytosphingosine, contributes to gene expression changes related to metabolic disorders in PDC individuals and increases their susceptibility to metabolic disorders. These findings suggest that diagnosing PDC may be beneficial for identifying at-risk populations among apparently healthy individuals, thereby advancing the broader field of metabolic disorder prevention and TCM integration.

Clinical and biochemical factors associated with amygdalar metabolic activity

We investigated clinical factors and biochemical markers associated with amygdalar metabolic activity evaluated by [18F]-fluorodeoxyglucose-positron emission tomography (FDG-PET) in 346 subjects without a history of malignant neoplasms. Univariate regression analysis revealed significant relationships between amygdalar metabolic activity and fasting plasma glucose (FPG), glycated hemoglobin, coronary artery disease (CAD) history, aspirin use, oral hypoglycemic agents (OHAs) use, and asymmetric dimethylarginine (ADMA). In multiple stepwise regression analysis, FPG and CAD history were independently associated with amygdalar metabolic activity. Moreover, in 36 patients with type 2 diabetes mellitus (T2DM), additional OHAs treatment significantly improved glycemic and metabolic parameters, and decreased ADMA concentrations. Baseline and Δpigment epithelium-derived factor (PEDF), a marker of insulin resistance, was a significant associate with Δamygdalar metabolic activity. Our study demonstrates that FPG and CAD history were independently associated with amygdalar metabolic activity in subjects without a history of malignant neoplasms. In T2DM patients, PEDF might regulate amygdala metabolic activity.

Clostridioides difficile infection induces a pro-inflammatory and pro-steatotic metabolic state in liver

Using a multi-omics approach, this study investigated Clostridioides difficile infection (CDI) as a direct contributor to hepatic dysmetabolism. Fifty-four C57BL/6 mice were divided into Control, Antibiotic control (Abx), and C. difficile-infected (C. diff) groups. The Abx and C. diff groups received antibiotics to induce gut dysbiosis, followed by C. difficile challenge in C. diff group. Mice were euthanized after 48 h to collect samples for multi-omics analyses. Liver metabolomics and transcriptomics pathway analyses revealed significant alterations in lipid metabolism, including dysregulation in glycerolipid, steroid, and energy metabolisms in C. difficile-infected mice. Metabolites and pathways associated with oxidative stress and inflammation were enriched. Gut metagenome-liver metabolome correlation analysis identified specific bacterial species correlating with differentially enriched liver metabolites involved in oxidative stress, amino acid, and uric acid metabolism. CDI triggers metabolic shifts that could facilitate steatosis and inflammation, suggesting that CDI could be a risk factor for metabolic liver diseases.

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