Loss of PTPMT1 limits mitochondrial utilization of carbohydrates and leads to muscle atrophy and heart failure

Reviewer #1 (Public Review):

The manuscript entitled, "Loss of PTPMT1 limits mitochondrial utilization of carbohydrates and leads to muscle atrophy and heart failure," by Zheng, et al., is focused on assessing the role of deletion of PTPMT1, a mitochondria-based phosphatase, in mitochondrial fuel selection. Authors show that the utilization of pyruvate, a key mitochondrial substrate derived from glucose, is inhibited, whereas fatty acid utilization is enhanced. Importantly, while the deletion of PTPMT1 does not impact development of skeletal muscle or heart, the metabolic inflexibility leads to muscular atrophy, heart failure, and sudden death. Mechanistically, authors claim that the prolonged substrate shift from carbohydrates to lipids causes oxidative stress and mitochondrial dysfunction, leading to accumulation of lipids and muscle cell and CM damage in the KO. Interestingly, PTPMT1 deletion from the liver or adipose tissue does not generate any local or systemic defects. Authors conclude that PTPMT1 plays an important role in maintaining mitochondrial flexibility and that the balanced utilization of carbohydrates and lipids is essential for skeletal muscle and heart. While interesting and authors did a ton of experiments for this project, several major concerns exist. First, because both the CKMM- and the MYHC-Cre express early, during development , it seems the effects of the deletion of PTPMT1 are more likely be specific to defects in muscle and cardiac development rather than postnatal, especially since loss of PTPMT1 affects mTOR activity; indeed, previous reports have shown that selective deletion of mTOR or raptor in skeletal muscle during embryonic development leads to a reduction in postnatal growth and the development of late-onset myopathy and premature death around 6 to 8 months of age. The effects of the deletion in muscle seem eerily similar and therefore likely mechanistically function the same -embryonically, as has been previously suggested. This is also true for cardiac abnormalities, where developmental defects can manifest in mice as they age after at least 3-4 months and decreased mTOR activity can lead to significant cardiac dysfunction and failure (similarly to the effects observed here by the authors). To prove one way or another, authors should show developmental data providing evidence that the effects are not occurring at this stage. It is a lot of work, but the right way to differentiate pre- vs post- development functions of PTPMT1 in the muscle and heart, otherwise cannot verify mechanistically what the precise cause for the phenotype may be. Authors could consider generating mice that have inducible Cre drivers. In addition, how is it that the effects of loss of PTPMT1 are similar between muscle and heart given the differences in energy usage and utilization between these two tissues? Increases in AMPK are usually associated with better metabolic outcomes, particularly in the heart. Increased AMPK activation has also been shown to help reduce fat storage, increase insulin sensitivity, reduce cholesterol/triglyceride production, and suppress chronic inflammation. In addition, increases in carnitines are associated with enhanced metabolic function. Carnitines facilitate transport of long-chain fatty acids into the mitochondrial matrix, triggering cardioprotective effects through reduced oxidative stress, inflammation and necrosis of cardiac myocytes. All of these factors are positive, so how do authors explain this discrepancy in their findings which suggest opposing outcomes- as above, I suggest the explanation is that it is due to developmental effects of deletion of PTPMT1.

Authors attribute much of the pathology in the muscle and heart due to increased lipid accumulation in these tissues; but how do authors explain how hearts and muscle have more fat when the mice are smaller than wt? Is there a difference in energy expenditure in the mice? What about changes in white fat, core temperature or browning of fat? Authors do not mechanistically prove that lipid accumulation is the cause of death in these animals. Rescue experiments should be considered.

Reviewer #2 (Public Review):

Zheng et al. have investigated the effects of PTPMT1 Knock-out on cellular metabolic flexibility. Using several types of appropriate tissue-specific mouse models, the authors have generated data that are both reasonable and broadly significant. While the central mechanism driving the metabolic fuel preference and flexibility remains elusive as the author mentioned in the main text, the finding that the absence of PTPMT1 inhibits glucose (pyruvate) utilization and promotes FAO, resulting in cellular stress and damage, particularly in skeletal and cardiac muscle cells, is intriguing and has practical implications for further research. However, some quantitative data are lacking and certain explanations may be misleading, warranting revisions.