Inhibition of Lipolysis with Acipimox Attenuates Post-Burn White Adipose Tissue Browning and Hepatic Fat Infiltration.

Extensive burn injuries promote an increase in the lipolysis of white adipose tissue (WAT), a complication that enhances post-burn hypermetabolism, contributing to hyperlipidemia and hepatic steatosis. The systemic increase of free fatty acids (FFA) due to burn-induced lipolysis and subsequent organ fatty infiltration may culminate in multiple organ dysfunction and ultimately, death. Thus, reducing WAT lipolysis to diminish the mobilization of FFAs may render an effective means to improve outcomes post-burn. Here, we investigated the metabolic effects of Acipimox, a clinically approved drug that suppresses lipolysis via inhibition of hormone-sensitive lipase (HSL). Using a murine model of thermal injury, we show that specific inhibition of HSL with Acipimox effectively suppresses burn-induced lipolysis in the inguinal WAT leading to lower levels of circulating FFAs at 7 days post-burn (p < 0.05). The FFA substrate shortage indirectly repressed the thermogenic activation of adipose tissue following injury, reflected by the decrease in protein expression of key browning markers, UCP-1 (p < 0.001) and PGC-1α (p < 0.01). Importantly, reduction of FFA mobilization by Acipimox significantly decreased liver weight and intracellular fat accumulation (p < 0.05), suggesting that it may also improve organ function post-burn. Our data validate the pharmacological inhibition of lipolysis as a potentially powerful therapeutic strategy to counteract the detrimental metabolic effects induced by burn.

[1]  M. Jeschke,et al.  Targeting fat browning in hypermetabolic conditions: a clinical perspective , 2020, Future science OA.

[2]  M. Hill,et al.  Acipimox Administration With Exercise Induces a Co-feedback Action of the GH, PP, and PYY on Ghrelin Associated With a Reduction of Peripheral Lipolysis in Bulimic and Healthy-Weight Czech Women: A Randomized Study , 2019, Front. Endocrinol..

[3]  M. Jeschke,et al.  NLRP3 Inflammasome Modulates Post-Burn Lipolysis and Hepatic Fat Infiltration via Fatty Acid Synthase , 2018, Scientific Reports.

[4]  C. Sale,et al.  Exercise-induced ‘browning’ of adipose tissues , 2018, Metabolism: clinical and experimental.

[5]  G. Mitchell,et al.  Adipose tissue deficiency of hormone-sensitive lipase causes fatty liver in mice , 2017, PLoS genetics.

[6]  M. Jeschke,et al.  Taming the Flames: Targeting White Adipose Tissue Browning in Hypermetabolic Conditions , 2017, Endocrine reviews.

[7]  Jieun Lee,et al.  Fatty acid oxidation is required for active and quiescent brown adipose tissue maintenance and thermogenic programing , 2017, Molecular metabolism.

[8]  M. Jeschke,et al.  The biochemical alterations underlying post-burn hypermetabolism. , 2017, Biochimica et biophysica acta. Molecular basis of disease.

[9]  M. Jeschke,et al.  Pathophysiological Response to Burn Injury in Adults , 2016, Annals of surgery.

[10]  M. Jeschke,et al.  White Adipose Tissue Browning: A Double-edged Sword , 2016, Trends in Endocrinology & Metabolism.

[11]  M. Jeschke Postburn Hypermetabolism: Past, Present, and Future , 2016, Journal of burn care & research : official publication of the American Burn Association.

[12]  Saeid Amini-Nik,et al.  Alternative Mechanism for White Adipose Tissue Lipolysis after Thermal Injury , 2015, Molecular medicine.

[13]  M. Jeschke,et al.  Burn Induces Browning of the Subcutaneous White Adipose Tissue in Mice and Humans , 2015, Cell reports.

[14]  J. Stephens,et al.  Metabolic Control by Inflammation and Immunity Fat in flames : influence of cytokines and pattern recognition receptors on adipocyte lipolysis , 2015 .

[15]  D. Stolz,et al.  Impact of Reduced ATGL-Mediated Adipocyte Lipolysis on Obesity-Associated Insulin Resistance and Inflammation in Male Mice. , 2015, Endocrinology.

[16]  J. Ellis,et al.  Adipose fatty acid oxidation is required for thermogenesis and potentiates oxidative stress-induced inflammation. , 2015, Cell reports.

[17]  L. Sidossis,et al.  Browning of subcutaneous white adipose tissue in humans after severe adrenergic stress (1160.5) , 2014, Cell metabolism.

[18]  Y. Tseng,et al.  Brown fat fuel utilization and thermogenesis , 2014, Trends in Endocrinology & Metabolism.

[19]  Bruce M. Spiegelman,et al.  What We Talk About When We Talk About Fat , 2014, Cell.

[20]  P. Arner,et al.  Partial Inhibition of Adipose Tissue Lipolysis Improves Glucose Metabolism and Insulin Sensitivity Without Alteration of Fat Mass , 2013, PLoS biology.

[21]  S. Najjar,et al.  Additive effects of nicotine and high-fat diet on hepatic steatosis in male mice. , 2012, Endocrinology.

[22]  T. Zimmers,et al.  Inflammation, organomegaly, and muscle wasting despite hyperphagia in a mouse model of burn cachexia , 2012, Journal of cachexia, sarcopenia and muscle.

[23]  G. Shulman,et al.  Mechanisms for Insulin Resistance: Common Threads and Missing Links , 2012, Cell.

[24]  S. Bernard,et al.  Dynamics of human adipose lipid turnover in health and metabolic disease , 2011, Nature.

[25]  D. Herndon,et al.  Long-Term Persistance of the Pathophysiologic Response to Severe Burn Injury , 2011, PloS one.

[26]  R. Zechner,et al.  Monoglyceride Lipase Deficiency in Mice Impairs Lipolysis and Attenuates Diet-induced Insulin Resistance* , 2011, The Journal of Biological Chemistry.

[27]  Sangdun Choi,et al.  Continuous 24-h nicotinic acid infusion in rats causes FFA rebound and insulin resistance by altering gene expression and basal lipolysis in adipose tissue. , 2011, American journal of physiology. Endocrinology and metabolism.

[28]  R. Zechner,et al.  Neutral lipid storage disease: genetic disorders caused by mutations in adipose triglyceride lipase/PNPLA2 or CGI-58/ABHD5. , 2009, American journal of physiology. Endocrinology and metabolism.

[29]  D. Chinkes,et al.  Pathophysiologic Response to Severe Burn Injury , 2008, Annals of surgery.

[30]  P. Iozzo,et al.  The lowering of hepatic fatty acid uptake improves liver function and insulin sensitivity without affecting hepatic fat content in humans. , 2008, American journal of physiology. Endocrinology and metabolism.

[31]  R. Zechner,et al.  Adipose Triglyceride Lipase and Hormone-sensitive Lipase Are the Major Enzymes in Adipose Tissue Triacylglycerol Catabolism* , 2006, Journal of Biological Chemistry.

[32]  E. Wagner,et al.  Defective Lipolysis and Altered Energy Metabolism in Mice Lacking Adipose Triglyceride Lipase , 2006, Science.

[33]  R. DeFronzo,et al.  Effect of a sustained reduction in plasma free fatty acid concentration on intramuscular long-chain fatty Acyl-CoAs and insulin action in type 2 diabetic patients. , 2005, Diabetes.

[34]  R. Zechner,et al.  Hormone-sensitive Lipase Deficiency in Mice Causes Diglyceride Accumulation in Adipose Tissue, Muscle, and Testis* , 2002, The Journal of Biological Chemistry.

[35]  B. Ahrén Reducing plasma free fatty acids by acipimox improves glucose tolerance in high-fat fed mice. , 2001, Acta physiologica Scandinavica.

[36]  K. Alberti,et al.  Mechanism of anti-lipolytic action of acipimox in isolated rat adipocytes , 1996, Diabetologia.

[37]  G. Biolo,et al.  Lipolysis in burned patients is stimulated by the beta 2-receptor for catecholamines. , 1994, Archives of surgery.

[38]  M. Walker,et al.  A Double Blind Study of the Effect of Acipimox on Serum Lipids, Blood Glucose Control and Insulin Action in Non‐obese Patients with Type 2 Diabetes Mellitus , 1992, Diabetic medicine : a journal of the British Diabetic Association.

[39]  L. Monti,et al.  Effect of acipimox, a lipid lowering drug, on growth hormone (GH) response to GH-releasing hormone in normal subjects , 1990, Journal of endocrinological investigation.

[40]  R. Wolfe,et al.  Regulation of Lipolysis in Severely Burned Children , 1987, Annals of surgery.

[41]  P. Lovisolo,et al.  Pharmacological profile of a new antilipolytic agent: 5-methyl-pyrazine-2-carboxylic acid 4-oxide (acipimox) (1) II - Antilipolytic and blood lipid lowering activity. , 1981, Pharmacological research communications.

[42]  D. Herndon,et al.  Association of postburn fatty acids and triglycerides with clinical outcome in severely burned children. , 2013, The Journal of clinical endocrinology and metabolism.