Investigating Ketone Bodies as Immunometabolic Countermeasures against Respiratory Viral Infections
Open accessAbstract
Respiratory viral infections remain a scourge, with seasonal influenza infecting millions and killing many thousands annually and viral pandemics, such as COVID-19, recurring every decade. Age, cardiovascular disease, and diabetes mellitus are risk factors for severe disease and death from viral infection. Immunometabolic therapies for these populations hold promise to reduce the risks of death and disability. Such interventions have pleiotropic effects that might not only target the virus itself but also enhance supportive care to reduce cardiopulmonary complications, improve cognitive resilience, and facilitate functional recovery. Ketone bodies are endogenous metabolites that maintain cellular energy but also feature drug-like signaling activities that affect immune activity, metabolism, and epigenetics. Here, we provide an overview of ketone body biology relevant to respiratory viral infection, focusing on influenza A and severe acute respiratory syndrome (SARS)-CoV-2, and discuss the opportunities, risks, and research gaps in the study of exogenous ketone bodies as novel immunometabolic interventions in these diseases.
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Ketones produced during ketogenic diets or fasting can impact immune function and may have therapeutic effects for COVID-19.
“Additionally, ketones, which are largely produced during either ketogenic diets or fasting periods, can impact immune function and may have possible therapeutic effects for COVID-19194.”
From SARS-CoV-2, COVID-19 and the aging immune system (2021) · cites this paper as [194]
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Macheret, N. A., THOTA, G. P., Hengist, A., Courville, A. B., Chen, K. Y., Brychta, R. J., Klein, R. J., Malandrino, N., Puchalska, P., Crawford, P. A., et al. (2026) · Metabolism · doi:10.1016/j.metabol.2026.156753 · Cited by 1 · see citing works
- Authors
- Stubbs, B. J., Koutnik, A. P., Goldberg, E. L., Upadhyay, V., Turnbaugh, P. J., Verdin, E., & Newman, J. C.
- Affiliations
- Buck Institute for Research on Aging (US)
- Florida Institute for Human and Machine Cognition (US)
- University of California, San Francisco (US)
- Corresponding author
- Newman, John C.
- ORCID
- Venue
- Med
- Publisher
- Elsevier BV
- Published
- 2020-12
- Volume
- 1
- Issue
- 1
- Pages
- 43-65
- ISSN
- 2666-6340 (ISSN-L)
- PMC
- PMC7362813
- OpenAlex
- W3043137980
- Cited by
- 71
- References
- 251
- Citations by year
- 2026: 8 · 2025: 7 · 2024: 11 · 2023: 11 · 2022: 16 · 2021: 12 · 2020: 6
- FWCI
- 1.43
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Med (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- Buck Institute for Research on Aging (T32 HL007185)
- National Institutes of Health (K08 AG048354)
- Topics
- Health Sciences › Medicine › Physiology › Diet and metabolism studies
- Health Sciences › Medicine › Physiology › Dietary Effects on Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- ketone bodies, immunometabolic therapy, respiratory viral infections, influenza A virus, SARS-CoV-2, COVID-19 pandemic, immunomodulation, metabolic signaling, diabetes mellitus, cardiovascular disease, age-related risk factors, cardiopulmonary complications, functional recovery
- MeSH terms
- COVID-19, SARS-CoV-2, Humans, Influenza, Human, Ketone Bodies, Pandemics
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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