1. Academic Validation
  2. Acetyl CoA Carboxylase Inhibition Reduces Hepatic Steatosis but Elevates Plasma Triglycerides in Mice and Humans: A Bedside to Bench Investigation

Acetyl CoA Carboxylase Inhibition Reduces Hepatic Steatosis but Elevates Plasma Triglycerides in Mice and Humans: A Bedside to Bench Investigation

  • Cell Metab. 2017 Aug 1;26(2):394-406.e6. doi: 10.1016/j.cmet.2017.07.009.
Chai-Wan Kim 1 Carol Addy 2 Jun Kusunoki 2 Norma N Anderson 1 Stanislaw Deja 3 Xiaorong Fu 3 Shawn C Burgess 3 Cai Li 2 Marcie Ruddy 2 Manu Chakravarthy 2 Steve Previs 2 Stuart Milstein 4 Kevin Fitzgerald 4 David E Kelley 2 Jay D Horton 5
Affiliations

Affiliations

  • 1 Departments of Internal Medicine and Molecular Genetics, University of Texas Southwestern Medical Center, Dallas, TX 75390-9046, USA.
  • 2 MRL, 2000 Galloping Hill Road, Kenilworth, NJ 07033, USA.
  • 3 Advanced Imaging Research Center and Department of Pharmacology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
  • 4 Alnylam Pharmaceuticals, 300 Third Street, Cambridge, MA 02142, USA.
  • 5 Departments of Internal Medicine and Molecular Genetics, University of Texas Southwestern Medical Center, Dallas, TX 75390-9046, USA. Electronic address: jay.horton@utsouthwestern.edu.
Abstract

Inhibiting lipogenesis prevents hepatic steatosis in rodents with Insulin resistance. To determine if reducing lipogenesis functions similarly in humans, we developed MK-4074, a liver-specific inhibitor of Acetyl-CoA Carboxylase (ACC1) and (ACC2), Enzymes that produce malonyl-CoA for fatty acid synthesis. MK-4074 administered to subjects with hepatic steatosis for 1 month lowered lipogenesis, increased ketones, and reduced liver triglycerides by 36%. Unexpectedly, MK-4074 increased plasma triglycerides by 200%. To further investigate, mice that lack ACC1 and ACC2 in hepatocytes (ACC dLKO) were generated. Deletion of ACCs decreased polyunsaturated fatty acid (PUFA) concentrations in liver due to reduced malonyl-CoA, which is required for elongation of essential fatty acids. PUFA deficiency induced SREBP-1c, which increased GPAT1 expression and VLDL secretion. PUFA supplementation or siRNA-mediated knockdown of GPAT1 normalized plasma triglycerides. Thus, inhibiting lipogenesis in humans reduced hepatic steatosis, but inhibiting ACC resulted in hypertriglyceridemia due to activation of SREBP-1c and increased VLDL secretion.

Keywords

SREBPs; acetyl-CoA carboxylase; hepatic steatosis; hypertriglyceridemia; inhibitors; lipogenesis; malonyl-CoA.

Figures
Products