Cited by 449Liver Disease Diagnosis and TreatmentCancer, Lipids, and MetabolismLipid metabolism and biosynthesis

The DOI matches its Crossref record; 45 of the 48 references it cites were found in a registry or an index; none of the 31 sources its claims cite is checked for support yet.

Reversal of diet-induced hepatic steatosis and hepatic insulin resistance by antisense oligonucleotide inhibitors of acetyl-CoA carboxylases 1 and 2

Open access
Savage, D. B.·2006·Journal of Clinical Investigation

Abstract

Hepatic steatosis is a core feature of the metabolic syndrome and type 2 diabetes and leads to hepatic insulin resistance. Malonyl-CoA, generated by acetyl-CoA carboxylases 1 and 2 (Acc1 and Acc2), is a key regulator of both mitochondrial fatty acid oxidation and fat synthesis. We used a diet-induced rat model of nonalcoholic fatty liver disease (NAFLD) and hepatic insulin resistance to explore the impact of suppressing Acc1, Acc2, or both Acc1 and Acc2 on hepatic lipid levels and insulin sensitivity. While suppression of Acc1 or Acc2 expression with antisense oligonucleotides (ASOs) increased fat oxidation in rat hepatocytes, suppression of both enzymes with a single ASO was significantly more effective in promoting fat oxidation. Suppression of Acc1 also inhibited lipogenesis whereas Acc2 reduction had no effect on lipogenesis. In rats with NAFLD, suppression of both enzymes with a single ASO was required to significantly reduce hepatic malonyl-CoA levels in vivo, lower hepatic lipids (long-chain acyl-CoAs, diacylglycerol, and triglycerides), and improve hepatic insulin sensitivity. Plasma ketones were significantly elevated compared with controls in the fed state but not in the fasting state, indicating that lowering Acc1 and -2 expression increases hepatic fat oxidation specifically in the fed state. These studies suggest that pharmacological inhibition of Acc1 and -2 may be a novel approach in the treatment of NAFLD and hepatic insulin resistance.

Overview

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Written from the paper’s full text.

TL;DR

In high-fat-fed rats with diet-induced hepatic steatosis and insulin resistance, antisense oligonucleotide knockdown of both Acc1 and Acc2 lowered hepatic malonyl-CoA and lipids and improved hepatic insulin sensitivity. The data suggest combined Acc1/Acc2 inhibition may be a therapeutic strategy for NAFLD and hepatic insulin resistance.

Key findings

  • Combined Acc1 and -2 ASO reduced hepatic ACC1 and ACC2 mRNA by approximately 80% and total Acc protein by approximately 90%, and lowered malonyl-CoA by 49% (P < 0.05) in refed rat liver; Acc1 or Acc2 ASO alone did not significantly alter malonyl-CoA.
  • In high-fat-fed rats, Acc1 and -2 ASO reduced hepatic triglycerides by 45% (P < 0.05), diacylglycerol by 30% (P < 0.05), and long-chain acyl-CoAs by 26% (P = 0.13), and increased fed-state plasma ketones by 83% (P < 0.05) but not fasting ketones.
  • Hyperinsulinemic-euglycemic clamps showed Acc1 and -2 ASO increased glucose infusion rates and insulin-mediated suppression of endogenous glucose production, without changing peripheral glucose metabolism; neither Acc1 nor Acc2 ASO alone significantly altered insulin sensitivity, and Acc1 and -2 ASO did not alter insulin sensitivity in chow-fed rats.
  • In primary rat hepatocytes, reducing either Acc1 or Acc2 increased fat oxidation, with Acc2 having a greater effect and combined knockdown being synergistic; lipogenesis was inhibited only by Acc1 and combined Acc1 and -2 ASOs, not by Acc2 alone.

Methods

  • Male Sprague-Dawley rats were fed chow or a high-fat diet (26% carbohydrate/59% fat/15% protein calories; safflower oil as major constituent); ASO therapy began 3 days after high-fat diet and was given i.p. at 50 mg/kg/wk for 4 weeks.
  • Primary rat hepatocytes were transfected with ASO (150 nM) and Lipofectin and assayed for [14C]oleate oxidation and [3H]glycerol incorporation into triglycerides.
  • In vivo metabolic assessment used hyperinsulinemic-euglycemic clamps with radioisotope infusions, plus RT-PCR, Western blot, lipid and malonyl-CoA measurements by LC/MS/MS; data analyzed by two-tailed Student’s t tests or 1-way ANOVA with Tukey HSD, significance at P < 0.05.

Limitations

  • The paper states that liver-specific Acc reduction did not lower body weight and that longer treatment might be needed for weight reduction; it also notes that ASOs did not alter hypothalamic target expression and no food-intake differences were detected.
  • The paper notes prior-model limitations: ACC2-null mice are substantially leaner than wild-type controls, making direct liver effects difficult to discern, and ACC1-null mice are embryonic lethal while ACC1+/- mice appear to have normal hepatocyte Acc1 protein levels.
  • Evident from the text: experiments used male Sprague-Dawley rats only, a 4-week high-fat diet model, and small group sizes (often 4–6 rats per group; 6–9 in clamp studies), with no human data.

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Integrity signals

Registry

Crossref · 10.1172/jci27300

Cites

45 of 45 references verified0 citation errors · 0 not checkable

Statistics

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Verification

Claims the paper makes

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Show all 96 claims

  • It may state two separate claims as one. 22
  • Probably not a substantial claim. 17
36 of 36
  • The paper relies on this without support.

    ACC1 and ACC2 exhibit considerable sequence identity (~85% excluding the N terminal extension of ACC2) and have the same domain structure responsible for enzyme activity.

    “Despite being encoded by separate genes, ACC1 and ACC2 exhibit considerable sequence identity (∼85% excluding the N terminal extension of ACC2) and have the same domain structure responsible for enzyme activity.”
  • The paper relies on this without support.

    Acc1 is localized in the cytosol, where it regulates lipogenesis in the liver and adipose tissue.

    “Acc1 is localized in the cytosol, where it is thought to regulate lipogenesis in the liver and adipose tissue.”
  • The paper relies on this without support.

    CPT1 regulates the transfer of long-chain acyl-CoAs from the cytosol into the mitochondria, where they are oxidized.

    “CPT1 regulates the transfer of long-chain acyl-CoAs (LCCoAs) from the cytosol into the mitochondria, where they are oxidized.”
  • The paper relies on this without support.

    Insulin resistance is a key element in the pathogenesis of type 2 diabetes and the metabolic syndrome.

    “Insulin resistance is in turn a key element in the pathogenesis of type 2 diabetes and the metabolic syndrome.”
  • The paper relies on this without support.

    Acc2 regulates malonyl-CoA levels in the immediate proximity of CPT1.

    “which is believed to regulate malonyl-CoA levels in the immediate proximity of CPT1.”
  • The paper relies on this without support.

    PEPCK and G6P are key regulators of hepatic glucose production.

    “PEPCK and G6P are key regulators of HGP”
  • The paper relies on this without support.

    Insulin suppresses endogenous glucose production, at least in part, by lowering mRNA levels of PEPCK and G6P.

    “insulin suppresses endogenous glucose production, at least in part, by lowering mRNA levels of PEPCK and G6P.”
  • The paper relies on this without support.

    Acc catalyzes a key rate-controlling step in both de novo lipogenesis and fatty acid oxidation.

    “Acc catalyzes a key rate-controlling step in both de novo lipogenesis and fatty acid oxidation.”
  • The paper relies on this without support.

    Plasma ketones are synthesized in the liver from acetyl-CoA derived from fatty acid oxidation and can be used as an indirect marker of hepatic fatty acid oxidation.

    “Plasma ketones are synthesized in the liver from acetyl-CoA derived from fatty acid oxidation and can, therefore, be used as an indirect marker of hepatic fatty acid oxidation.”
  • The paper relies on this without support.

    The hypothesis that cytosolic Acc1 regulates malonyl-CoA synthesis for incorporation into fatty acids, whereas Acc2 regulates mitochondrial fatty acid oxidation, has never been directly tested.

    “this hypothesis has never been directly tested”
  • The paper relies on this without support.

    The rat high-fat diet model of hepatic steatosis and insulin resistance is predictive of human NAFLD and hepatic insulin resistance.

    “Thus, hepatic Acc1 and -2 inhibitors may be useful in the treatment of NAFLD and hepatic insulin resistance.”
11 of 11

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Metadata

Authors
Savage, D. B.
Affiliations
Yale University (US)
Corresponding author
Savage, D. B.
Venue
Journal of Clinical Investigation
Published
2006-03-01
Volume
116
Issue
3
Pages
817-824
ISSN
0021-9738 (ISSN-L)
OpenAlex
W2168436114
Cited by
447
References
48
Citations by year
2026: 7 · 2025: 11 · 2024: 13 · 2023: 17 · 2022: 21 · 2021: 17 · 2020: 25 · 2019: 14 · 2018: 27 · 2017: 17 · 2016: 27 · 2015: 20 · 2014: 27 · 2013: 21 · 2012: 28
FWCI
23.28
Type
journal article
Language
en
Open access
Locations
  • Journal of Clinical Investigation (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Howard Hughes Medical Institute
  • American Diabetes Association
  • Wellcome Trust
  • National Institute of Diabetes and Digestive and Kidney Diseases (P30DK45735, R01-DK40936, R01DK040936, P30DK045735)
Topics
  • Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Lipids, and Metabolism
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Biochemistry › Lipid metabolism and biosynthesis
Keywords
acetyl-CoA carboxylase 1, acetyl-CoA carboxylase 2, antisense oligonucleotides, hepatic steatosis, non-alcoholic fatty liver disease, hepatic insulin resistance, malonyl-CoA, fatty acid oxidation, lipogenesis, metabolic syndrome, type 2 diabetes, plasma ketones, hepatocytes
MeSH terms
Acetyl-CoA Carboxylase, Animals, Diet, Enzyme Inhibitors, Fatty Acids, Fatty Liver, Insulin Resistance, Triglycerides, Signal Transduction, Oligonucleotides, Antisense, Hepatocytes, Rats

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