Metabolic adaptation of skeletal muscle to hyperammonemia drives the beneficial effects of l-leucine in cirrhosis.

Metabolic adaptation of skeletal muscle to hyperammonemia drives the beneficial effects of l-leucine in cirrhosis.
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DOI:
10.1016/j.jhep.2016.06.004
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发表时间:
2016-11
影响因子:
25.7
通讯作者:
Dasarathy S
Dasarathy S
中科院分区:
医学1区
文献类型:
--
作者:
Davuluri G;Krokowski D;Guan BJ;Kumar A;Thapaliya S;Singh D;Hatzoglou M;Dasarathy S

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Increased skeletal muscle ammonia uptake with loss of muscle mass adversely affects clinical outcomes in cirrhosis. Hyperammonemia causes reduced protein synthesis and sarcopenia but the cellular responses to impaired proteostasis and molecular mechanism of L-leucine induced adaptation to ammonia-induced stress were determined. Response to activation of amino acid deficiency sensor, GCN2, in the skeletal muscle from cirrhotic patients and the portacaval anastomosis (PCA) rat were quantified. During hyperammonemia and L-leucine supplementation, protein synthesis, phosphorylation of eIF2α, mTORC1 signaling, L-leucine transport and response to L-leucine supplementation were quantified. Adaptation to cellular stress via ATF4 and its target GADD34 were also determined. Activation of the eIF2α kinase GCN2 and impaired mTORC1 signaling were observed in skeletal muscle from cirrhotic patients and PCA rats. Ammonia activated GCN2 mediated eIF2α phosphorylation (eIF2α–P) and impaired mTORC1 signaling that inhibit protein synthesis in myotubes and MEFs. Adaptation to ammonia-induced stress did not involve translational reprogramming by activation transcription factor 4 (ATF4) dependent induction of the eIF2α-P phosphatase subunit GADD34. Instead, ammonia increased expression of the leucine/glutamine exchanger SLC7A5, L-leucine uptake and intracellular L-leucine levels, the latter not being sufficient to rescue the inhibition of protein synthesis, due to potentially enhanced mitochondrial sequestration of L-leucine. L-leucine supplementation rescued protein synthesis inhibition caused by hyperammonemia. Response to hyperammonemia is reminiscent of the cellular response to amino acid starvation, but lacks the adaptive ATF4 dependent integrated stress response (ISR). Instead, hyperammonemia-induced L-leucine uptake was an adaptive response to the GCN2-mediated decreased protein synthesis.
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