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Metabolic Basis of Creatine in Health and Disease: A Bioinformatics-Assisted Review

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Bonilla, Diego A., Kreider, Richard B., Stout, Jeffrey R., Forero, Diego A., Kerksick, Chad M., Roberts, Michael D., Rawson, Eric S.·2021·Nutrients
DOI 10.3390/nu13041238PMC PMC8070484
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Abstract

Creatine (Cr) is a ubiquitous molecule that is synthesized mainly in the liver, kidneys, and pancreas. Most of the Cr pool is found in tissues with high-energy demands. Cr enters target cells through a specific symporter called Na+/Cl−-dependent Cr transporter (CRT). Once within cells, creatine kinase (CK) catalyzes the reversible transphosphorylation reaction between [Mg2+:ATP4−]2− and Cr to produce phosphocreatine (PCr) and [Mg2+:ADP3−]−. We aimed to perform a comprehensive and bioinformatics-assisted review of the most recent research findings regarding Cr metabolism. Specifically, several public databases, repositories, and bioinformatics tools were utilized for this endeavor. Topics of biological complexity ranging from structural biology to cellular dynamics were addressed herein. In this sense, we sought to address certain pre-specified questions including: (i) What happens when creatine is transported into cells? (ii) How is the CK/PCr system involved in cellular bioenergetics? (iii) How is the CK/PCr system compartmentalized throughout the cell? (iv) What is the role of creatine amongst different tissues? and (v) What is the basis of creatine transport? Under the cellular allostasis paradigm, the CK/PCr system is physiologically essential for life (cell survival, growth, proliferation, differentiation, and migration/motility) by providing an evolutionary advantage for rapid, local, and temporal support of energy- and mechanical-dependent processes. Thus, we suggest the CK/PCr system acts as a dynamic biosensor based on chemo-mechanical energy transduction, which might explain why dysregulation in Cr metabolism contributes to a wide range of diseases besides the mitigating effect that Cr supplementation may have in some of these disease states.

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  • For a dietary source of creatine to be bioavailable, creatine must be absorbed as creatine into the blood and transported to tissues, transported into tissue via tissue-specific creatine transporter genes, and increase tissue and cellular creatine and PCr content by a physiologically meaningful amount (e.g., 20-40% in muscle and 10-20% in brain).

    “For a dietary source of creatine to be bioavailable, creatine must be: (1) absorbed as creatine into the blood and transported to tissues [2,25]; (2) transported into tissue via tissue-specific creatine transporter genes (e.g., CRT1 or SLC6A8 in muscle) [6,7]; and (3) increase tissue and cellular creatine and PCr content by a physiologically meaningful amount to influence metabolic activity (e.g.,”

    From Bioavailability, Efficacy, Safety, and Regulatory Status of Creatine and Related Compounds: A Critical Review (2022) · cites this paper as [7]

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Authors
Bonilla, D. A., Kreider, R. B., Stout, J. R., Forero, D. A., Kerksick, C. M., Roberts, M. D., & Rawson, E. S.
Affiliations
  • University of the Basque Country (ES)
  • Texas A&M University (US)
  • University of Central Florida (US)
  • Fundación Universitaria del Área Andina (CO)
  • Lindenwood University (US)
  • Auburn University (US)
  • Messiah University (US)
Corresponding author
Bonilla, Diego A.
ORCID
Venue
Nutrients
Publisher
MDPI AG
Published
2021-04-09
Volume
13
Issue
4
Pages
1238
ISSN
2072-6643 (ISSN-L)
DOI
10.3390/nu13041238
PMC
PMC8070484
OpenAlex
W3153762077
Cited by
223
References
21
Citations by year
2026: 60 · 2025: 68 · 2024: 46 · 2023: 22 · 2022: 17 · 2021: 10
FWCI
3.05
Type
journal article
Language
en
Open access
Licence
Locations
  • Nutrients (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cell Biology › Muscle metabolism and nutrition
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Biochemistry › Amino Acid Enzymes and Metabolism
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Metabolism and Genetic Disorders
Keywords
creatine metabolism, creatine kinase, phosphocreatine, creatine transport, cellular bioenergetics, allostasis, creatine supplementation
MeSH terms
Animals, Biological Transport, Creatine, Creatine Kinase, Disease, Health, Humans, Computational Biology

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