Breathtaking organelles in vital bodies; in vivo measures of mitochondrial function

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Breathtaking organelles in vital bodies; in vivo measures of mitochondrial function Matthijs Hesselink Nutrition and Toxicology Research Institute Maastricht (NUTRIM) Department of Human Movement Sciences Maastricht University The Netherlands www.hb.unimaas.nl/muscle

Mitochondrial function defined The ability of a mitochondrion to adjust oxidative degradation of lipids and carbohydrates to a variety in energy demand and supply

In vivo methods defined Measuring mitochondrial function non-invasively Methods based on breath gas analyses (whole body VO 2 & VCO 2 ) Respiration Chambers Ventilated hood Face mask/mouth piece based systems Any of the above combined with ( 13 C) tracer analysis Methods based on non-invasively measuring mitochondrial metabolites or indirect markers thereof NMR based systems (ATP saturation transfer, 31 PCr resynthesis rate) PET Scan Thermal recorders

Methods based on breath gas analyses common denominator Measuring ambient air conditions % O 2 % CO 2 T P Humidity Measuring exhaled air conditions % O 2 % CO 2 T P Humidity

Methods based on breath gas analyses common denominator Convert to Standard Temperature Pressure Dry (STPD) Measuring flow (face and mouth masks) or Create standard flow (ventilated hood and respiration chambers) Compute whole body O 2 uptake and CO 2 production VO 2 = V(e) x (FiO 2 - FeO 2 ) So, for example if V(e) = 24.5 liters/min FeO 2 = 0.1602 FiO 2 = 0.2093 (20.93%) VO 2 = 24.5 x (0.2093 -.1602) = 1.20 liters of O 2 per minute VCO 2 = V(e) x (FeCO 2 FiCO 2 ) So, for example if V(e) = 24.5 liters/min FeCO 2 = 0.0388 FiCO 2 = 0.0003 (0.03%) VCO 2 = 24.5 x ( 0.0388 0.0003 ) = 0.94 liters of CO 2 per minute

Methods based on breath gas analyses post-processing the data Compute Respiratory Exchange Ratio (RER) Respiratory Quotient (RQ) VCO 2 /VO 2 RQ Glucose C 6 H 12 O 6 + 6O 2 6CO 2 + 6H 2 0 RQ =6/6 =1.00 RQ Palmitate C 16 H 32 O 2 + 23O 2 16CO 2 + 16H 2 O RQ =16/23 = 0,696 Under aerobic conditions 0.696 > RQ < 1.00

Methods based on breath gas analyses post-processing the data Energy provided O 2 required kj/l O 2 1 g Glucose 16 kj 0,75 l 22 1 g Fat (depends on C) 41 kj 2,00 l 20 CHO oxidation = 4,585*VCO 2-3,226*VO 2 Fat oxidation = 1,695*VCO 2-1,701*VO 2 Valid for steady state conditions and RQ<1.00

Breath gas analyses mouth piece Measuring flow by turbidometry Breath-by-breath analyses possible Measuring ventilatory rate and volume Suitable for exercise, not (hardly) for resting conditions Allows analyses of substrate selection during exercise

Breath gas analyses Respiration chamber Flow through chamber pre-set, but adjustable No measures of ventilatory rate and volume Suitable for assessing RMR & SMR as well as exercise with very accurate measures of substrate selection All other conditions (diet, mobility, faeces, urine samples) controlled or collected Schoffelen et al., JAP 1997

Respiration chamber to measure energy expenditure Schoffelen et al., JAP 1997

Respiration chamber to measure substrate selection Etomoxir blocks CPT1 (mitochondrial entry of long chain fatty acids) 36 Hours stay + exercise in the chamber (only water provided, black circles etomoxir), Schrauwen et al., FASEB J 2002

Breath gas analyses ventilated hood Flow through hood pre-set No measures of ventilatory rate and volume Suitable for assessing RMR Allows analyses of substrate selection during interventions

Ventilated hood to measure metabolic flexibility Insulin-mediated increase in CHO oxidation blunted in obese and T2D Leg RQ extended to whole body Mitochondrial phenomenon? Kelley et al., Diabetes 2000

Ventilated hood based metabolic flexibility effect of exercise training T2D Controls (n = 20) T2D (n = 18) Age (Years) Weight (kg) Length (cm) BMI (kg/m 2 ) 59 ± 1 95 ± 3 179 ± 1 30 ± 1 59 ± 1 94 ± 3 177 ± 1 30 ± 1 Meex et al. in progress

Ventilated hood based metabolic flexibility effect of exercise training T2D Maximal power output 300 250 * * 200 watt 150 100 50 0 Data are means ± SE Control subjects before training Diabetic subjects after training Meex et al., in progress

Ventilated hood based metabolic flexibility effect of exercise training T2D Metabolic flexibility 0.90 0.88 RQ 0.86 0.84 Metabolic flexibility control subjects before training 0.82 0.80 0.78 RQ 0.90 0.88 0.86 0.84 Basal 0.82 Insulin stimulated Data are means ± SE diabetic subjects before training controle subjects after training diabetic subjects after training 0.80 0.78 Basal Insulin stimulated Meex et al., in progress

Ventilated hood based metabolic flexibility effect of exercise training T2D Metabolic flexibility 0.12 insulin stimulated FATox-basal insulin stimulated RQ-basal RQ insulin stimulated CHOox-basal FATox (g/min) CHOox (g/min) 0.10 0.08 0.06 0.04 8.00 0.027.00 0.00 0.006.00-0.50 5.00-1.00 4.00 3.00-1.50 2.00-2.00 1.00 0.00-2.50-3.00 Control subjects * Carbohydrate oxidation FAT oxidation * Control subjects Diabetic subjects Control subjects Diabetic subjects Diabetic subjects * RQ before training RQ after training CHOox before training CHOox after training FATox before training FATox after training

Q: Does metabolic inflexibility reflect insulin resistance?

Training T2D restores metabolic flexibility Metabolic flexibility insulin stimulated RQ-basal RQ 0,12 0,10 0,08 0,06 0,04 0,02 0,00 Data are means ± SE Control subjects Diabetic subjects RQ before training RQ after training Meex et al., in progress

Exercise training in T2D and controls improves, not restores, insulin sensitivity Glucose infusion rate 35 30 * umol/min/kg BM 25 20 15 10 * 5 0 Data are means ± SE Control subjects diabetic subjects before training after training Meex et al., in progress

Q: Do the many faces of insulin require the same concentration of insulin?

Faces of insulin and concentrations (μu/ml) for computed ½ max effect FAT LIPOLYSIS 20 Na-K-ATP-ase POTASSIUM 25 GLUCOSE OXIDATION 28 GLUCOSE PRODUCTION 29 GLUCOSE UPTAKE 65 GLUCOSE GLYCOGEN SYNTHESIS 109 PROTEIN PROTEOLYSIS 32 Data compiled by Prof H. P. Sauerwein

1,2-13 C acetate to measure TCA cycle activity breath gas analyses after venous infusion 13 C label lost in TCA-cycle exchange reactions The higher TCA cycle flux; the more 13 C exchange More exchange => less recovery of 13 C as 13 CO 2 Data are means ± SE Schrauwen & Hesselink, Diabetologia, 2008

1,2-13 C acetate to measure TCA cycle activity breath gas analyses after venous infusion 13C Acetate recovery in CO2 90 80 70 60 50 40 30 20 10 0 Data are means ± SE Lean Healthy 1 Obese T2D Schrauwen & Hesselink, Diabetologia, 2008

1,2-13 C acetate lower with incremental body fat and ageing Data are means ± SE Schrauwen et al., Clin Sci 2000

NMR-based methods 2-13 C-acetate incorporation in 4-13 C-glu for TCA cycle flux Jucker et al., PNAS 2000

NMR-based methods 31 P saturation transfer: unidirectional ATP synthase flux (ΔM) Transfer of saturated γ-atp, via PCr results in decline in saturated P i (ΔM) Unidirectional Very low signal Pi + CR PCr 2- + MgADP - + H + Cr + MgATP 2- Jucker et al., PNAS 2000

NMR-based methods 31 P saturation transfer combined with 13 C acetate T3 treatment reduces mitochondrial coupling Lebon et al., JCI 2001 TCA cycle flux and ATP synthesis declined in IR elderly Petersen et al., Science 2003

NMR-based methods 31 P-NMR post-exercise PCr resynthesis rate PCr kg Pi ATP 7.5 0-7.5-15 relative resonance frequency (ppm) Schrauwen-Hiderling et al., Diabetologia 2007

NMR-based methods 31 P-NMR post-exercise PCr resynthesis rate recovery exercise Meyer et al., 1988

NMR-based methods 31 P-NMR post-exercise PCr resynthesis rate PCr PCr resynthesis is almost purely aerobic time PCr recovery half-time reflects oxidative capacity

NMR-based methods 31 P-NMR post-exercise PCr resynthesis rate Monoexponential curve for PCr recovery: PCr(t) = [PCr] endex + D * [1-e -(k * t) ] k = timeconstant D = [PCr]rest- [PCr]endex Low k slow repletion Time constant k (and t 1/2 = 0.693/k); independent of work or force, used as indicator of mitochondrial function Prevent exercise-induced ph differences

NMR-based methods 31 P-NMR post-exercise PCr resynthesis rate fast recovery good mito function slow recovery bad mito function PCr (relative units) t 1/2 = 14 sec PCr (relative units) t 1/2 = 33 sec time (s) time (s) Schrauwen-Hiderling et al., Diabetologia 2007

In vivo mitochondrial function reduced in T2DM PCr recovery (seconds) 35 30 25 20 15 10 5 * 0 CON DM Schrauwen-Hinderling et al., Diabetologia 2007

Lower in vivo mitochondrial function in T2DM and first-degree relatives * 30 25 P=0.08 PCr half-time (s) 20 15 10 5 0 Control FDR T2DM Phielix et al., Diabetes 2008

Insulin sensitizing by rosiglitazone Effect on in vivo mitochondrial function in T2D Rosiglitazone treatment does not improve mitochondrial function Delta blood glucose correlates with delta mitochondrial function

NMR-based methods 31 P-NMR post-exercise PCr resynthesis rate (rats) Tibialis anterior muscle 31 P De Feyter et al., FASEB J 2008

NMR-based methods 31 P-NMR post-exercise PCr resynthesis rate (rats) De Feyter et al., FASEB J 2008

NMR-based methods 31 P-NMR post-exercise PCr resynthesis rate (rats) 140 120 100 fa/fa fa/+ tau_pcr 80 60 40 20 0 6 weeks 12 weeks 18 weeks De Feyter et al., FASEB J 2008

Post-exercise ph similar End exercise ph 6 weeks 12 weeks 18 weeks fa/fa 6.86 6.98 6.95 fa/+ 6.91 7.02 6.96 De Feyter et al., FASEB J 2008

PET scanning/thermal recorders PET allows measuring substrate uptake in cell/tissue regions Thermal recording reflects metabolic activity Combined PET and thermal recording allows examining metabolic consequences of activation of brown adipose tissue, also in humans Cold exposing humans activates subscapular BAT in humans and enhances F-DOG uptake (under review)

Thanks to Patrick Schrauwen Ruth Meex Vera Schrauwen-Hinderling Gert Schaart Esther Kornips Johan de Vogel Noud van Herpen Miranda Nabben Henk de Feyter TuE Joris Hoeks Esther Phielix Ellen Lenaers Ronnie Minnaard Denis van Beurden Katarina Fredriksson Johanna Jörgensen Silvie Timmers Jeanine Prompers TuE