Gut microbe-targeted choline trimethylamine lyase inhibition improves obesity via rewiring of host circadian rhythms
- Cleveland Clinic Lerner College of Medicine, United States
- University of Texas Southwestern Medical Center, United States
- University of California, Los Angeles, United States
- National Institute of Standards and Technology (NIST), United States
- Rush University Medical Center, United States
- Procter and Gamble, United States
Abstract
Obesity has repeatedly been linked to reorganization of the gut microbiome, yet to this point obesity therapeutics have been targeted exclusively toward the human host. Here we show that gut microbe-targeted inhibition of the trimethylamine N-oxide (TMAO) pathway protects mice against the metabolic disturbances associated with diet-induced obesity (DIO) or leptin deficiency (Lepob/ob). Small molecule inhibition of the gut microbial enzyme choline TMA-lyase (CutC) does not reduce food intake but is instead associated with alterations in the gut microbiome, improvement in glucose tolerance, and enhanced energy expenditure. We also show that gut microbial CutC inhibition is associated with reorganization of host circadian control of both phosphatidylcholine and energy metabolism. This study underscores the relationship between microbe and host metabolism and provides evidence that gut microbe-derived trimethylamine (TMA) is a key regulator of the host circadian clock. This work also demonstrates that gut microbe-targeted enzyme inhibitors have potential as anti-obesity therapeutics.
Data availability
RNA sequencing data has been deposited in GEO under accession code GSE157925Microbiome data were submitted to the European Nucleotide Archive under accession code PRJEB48232
Article and author information
Author details
Jonathan Mark Brown
Funding
National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK120679)
- Jonathan Mark Brown
National Heart, Lung, and Blood Institute (R01 HL130819)
- Zeneng Wang
National Institute of Diabetes and Digestive and Kidney Diseases (F32 DK122623)
- Christy M Gliniak
National Institute of Diabetes and Digestive and Kidney Diseases (T32 DK007307)
- Christy M Gliniak
Leducq Transatlantic Network of Excellence awar (No grant number)
- Stanley L Hazen
American Heart Association (17POST3285000)
- Robert N Helsley
American Heart Association (15POST2535000)
- Rebecca C Schugar
Clinical and Translational Science Collaborative of Cleveland, School of Medicine, Case Western Reserve University (4UL1TR000439)
- Belinda Willard
Case Comprehensive Cancer Center, Case Western Reserve University (P30 CA043703)
- Jonathan Mark Brown
National Heart, Lung, and Blood Institute (P01 HL146823)
- Stanley L Hazen
National Institute on Alcohol Abuse and Alcoholism (P50 AA024333)
- Jonathan Mark Brown
National Institute on Alcohol Abuse and Alcoholism (U01 AA026938)
- Jonathan Mark Brown
National Institute of Diabetes and Digestive and Kidney Diseases (R01 DK130227)
- Jonathan Mark Brown
National Cancer Institute (P50 CA150964)
- Jonathan Mark Brown
National Heart, Lung, and Blood Institute (R01 HL103866)
- Stanley L Hazen
National Heart, Lung, and Blood Institute (R01 HL147883)
- Aldons J Lusis
National Heart, Lung, and Blood Institute (R01 HL144651)
- Aldons J Lusis
The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.
Ethics
Animal experimentation: All mice were maintained in an Association for the Assessment and Accreditation of Laboratory Animal Care, International-approved animal facility, and all experimental protocols were approved by the Institutional Animal Care and use Committee of the Cleveland Clinic. (Approved IACUC protocol numbers 2015-1381, 2018-1941, and 00002499).
Copyright
© 2022, Schugar et al.
This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.
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Gut microbe-targeted choline trimethylamine lyase inhibition improves obesity via rewiring of host circadian rhythms
eLife 11:e63998.
https://doi.org/10.7554/eLife.63998
Further reading
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Background:
Subarachnoid hemorrhage (SAH) is characterized by intense central inflammation, leading to substantial post-hemorrhagic complications such as vasospasm and delayed cerebral ischemia. Given the anti-inflammatory effect of transcutaneous auricular vagus nerve stimulation (taVNS) and its ability to promote brain plasticity, taVNS has emerged as a promising therapeutic option for SAH patients. However, the effects of taVNS on cardiovascular dynamics in critically ill patients, like those with SAH, have not yet been investigated. Given the association between cardiac complications and elevated risk of poor clinical outcomes after SAH, it is essential to characterize the cardiovascular effects of taVNS to ensure this approach is safe in this fragile population. Therefore, this study assessed the impact of both acute and repetitive taVNS on cardiovascular function.
Methods:
In this randomized clinical trial, 24 SAH patients were assigned to either a taVNS treatment or a sham treatment group. During their stay in the intensive care unit, we monitored patient electrocardiogram readings and vital signs. We compared long-term changes in heart rate, heart rate variability (HRV), QT interval, and blood pressure between the two groups. Additionally, we assessed the effects of acute taVNS by comparing cardiovascular metrics before, during, and after the intervention. We also explored acute cardiovascular biomarkers in patients exhibiting clinical improvement.
Results:
We found that repetitive taVNS did not significantly alter heart rate, QT interval, blood pressure, or intracranial pressure (ICP). However, repetitive taVNS increased overall HRV and parasympathetic activity compared to the sham treatment. The increase in parasympathetic activity was most pronounced from 2 to 4 days after initial treatment (Cohen’s d = 0.50). Acutely, taVNS increased heart rate, blood pressure, and peripheral perfusion index without affecting the corrected QT interval, ICP, or HRV. The acute post-treatment elevation in heart rate was more pronounced in patients who experienced a decrease of more than one point in their modified Rankin Score at the time of discharge.
Conclusions:
Our study found that taVNS treatment did not induce adverse cardiovascular effects, such as bradycardia or QT prolongation, supporting its development as a safe immunomodulatory treatment approach for SAH patients. The observed acute increase in heart rate after taVNS treatment may serve as a biomarker for SAH patients who could derive greater benefit from this treatment.
Funding:
The American Association of Neurological Surgeons (ALH), The Aneurysm and AVM Foundation (ALH), The National Institutes of Health R01-EB026439, P41-EB018783, U24-NS109103, R21-NS128307 (ECL, PB), McDonnell Center for Systems Neuroscience (ECL, PB), and Fondazione Neurone (PB).
Clinical trial number:
