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Immunometabolism is a branch of
biology Biology is the scientific study of life. It is a natural science with a broad scope but has several unifying themes that tie it together as a single, coherent field. For instance, all organisms are made up of cells that process hereditary i ...
that studies the interplay between
metabolism Metabolism (, from el, μεταβολή ''metabolē'', "change") is the set of life-sustaining chemical reactions in organisms. The three main functions of metabolism are: the conversion of the energy in food to energy available to run cell ...
and
immunology Immunology is a branch of medicineImmunology for Medical Students, Roderick Nairn, Matthew Helbert, Mosby, 2007 and biology that covers the medical study of immune systems in humans, animals, plants and sapient species. In such we can see there ...
in all
organism In biology, an organism () is any living system that functions as an individual entity. All organisms are composed of cells (cell theory). Organisms are classified by taxonomy into groups such as multicellular animals, plants, and ...
s. In particular, immunometabolism is the study of the molecular and biochemical underpinninngs for i) the metabolic regulation of immune function, and ii) the regulation of metabolism by molecules and cells of the immune system. Further categorization includes i) systemic immunometabolism and ii) cellular immunometabolism. Immunometabolism first appears in academic literature in 2011, where it is defined as "an emerging field of investigation at the interface between the historically distinct disciplines of immunology and metabolism." A later article defines immunometabolism as describing "the changes that occur in intracellular metabolic pathways in immune cells during activation". Broadly, immunometabolic research records the
physiological Physiology (; ) is the scientific study of functions and mechanisms in a living system. As a sub-discipline of biology, physiology focuses on how organisms, organ systems, individual organs, cells, and biomolecules carry out the chemical ...
functioning of the immune system in the context of different metabolic conditions in health and disease. These studies can cover molecular and cellular aspects of immune system function ''
in vitro ''In vitro'' (meaning in glass, or ''in the glass'') studies are performed with microorganisms, cells, or biological molecules outside their normal biological context. Colloquially called "test-tube experiments", these studies in biology an ...
'', ''
in situ ''In situ'' (; often not italicized in English) is a Latin phrase that translates literally to "on site" or "in position." It can mean "locally", "on site", "on the premises", or "in place" to describe where an event takes place and is used in ...
'', and ''
in vivo Studies that are ''in vivo'' (Latin for "within the living"; often not italicized in English) are those in which the effects of various biological entities are tested on whole, living organisms or cells, usually animals, including humans, and ...
,'' under different metabolic conditions. For example, highly proliferative cells such as cancer cells and activating
T cell A T cell is a type of lymphocyte. T cells are one of the important white blood cells of the immune system and play a central role in the adaptive immune response. T cells can be distinguished from other lymphocytes by the presence of a T-cell r ...
s undergo metabolic reprogramming, increasing glucose uptake to shift towards aerobic glycolysis during normoxia. While aerobic glycolysis is an inefficient pathway for ATP production in quiescent cells, this so-called “Warburg effect” supports the bioenergetic and biosynthetic needs of rapidly proliferating cells.


Signalling and metabolic network

There are many indispensable signalling molecules connected to metabolic processes, which play an important role in both the immune system homeostasis and in the immune response. From these the most significant are mammalian target of
rapamycin Sirolimus, also known as rapamycin and sold under the brand name Rapamune among others, is a macrolide compound that is used to coat coronary stents, prevent organ transplant rejection, treat a rare lung disease called lymphangioleiomyomatosis, ...
(
mTOR The mammalian target of sirolimus, rapamycin (mTOR), also referred to as the mechanistic target of rapamycin, and sometimes called FK506-binding protein 12-rapamycin-associated protein 1 (FRAP1), is a kinase that in humans is encoded by the ''MT ...
), liver kinase B1 ( LBK1), 5' AMP-activated protein kinase (
AMPK AMPK may refer to: * AMP-activated protein kinase 5' AMP-activated protein kinase or AMPK or 5' adenosine monophosphate-activated protein kinase is an enzyme (EC 2.7.11.31) that plays a role in cellular energy homeostasis, largely to activate gl ...
), phosphoinositide 3 kinase (
PI3K Phosphoinositide 3-kinases (PI3Ks), also called phosphatidylinositol 3-kinases, are a family of enzymes involved in cellular functions such as cell growth, proliferation, differentiation, motility, survival and intracellular trafficking, which i ...
) and protein kinase B (
akt Protein kinase B (PKB), also known as Akt, is the collective name of a set of three serine/threonine-specific protein kinases that play key roles in multiple cellular processes such as glucose metabolism, apoptosis, cell proliferation, tran ...
). All of the aforementioned molecules together control the most important metabolic pathways in cells like
glycolysis Glycolysis is the metabolic pathway that converts glucose () into pyruvate (). The free energy released in this process is used to form the high-energy molecules adenosine triphosphate (ATP) and reduced nicotinamide adenine dinucleotide (NADH ...
,
krebs cycle The citric acid cycle (CAC)—also known as the Krebs cycle or the TCA cycle (tricarboxylic acid cycle)—is a series of chemical reactions to release stored energy through the oxidation of acetyl-CoA derived from carbohydrates, fats, and protein ...
or
oxidative phosphorylation Oxidative phosphorylation (UK , US ) or electron transport-linked phosphorylation or terminal oxidation is the metabolic pathway in which cells use enzymes to oxidize nutrients, thereby releasing chemical energy in order to produce adenosine tri ...
. To fully understand how all of these molecules and pathways affect the immune cells, it is first needed to examine the delicate interplay of these molecules.


mTOR

mTOR is a serine/threonine protein kinase, which is found in 2 complexes in cells: mTOR complex 1 and 2 (
mTORC1 mTORC1, also known as mammalian target of rapamycin complex 1 or mechanistic target of rapamycin complex 1, is a protein complex that functions as a nutrient/energy/redox sensor and controls protein synthesis. mTOR Complex 1 (mTORC1) is compo ...
and mTORC2). mTORC1 is activated through the T cell receptor ( TCR) and the costimulatory molecule cluster of differentiation 28 (
CD28 CD28 (Cluster of Differentiation 28) is one of the proteins expressed on T cells that provide co-stimulatory signals required for T cell activation and survival. T cell stimulation through CD28 in addition to the T-cell receptor ( TCR) can provid ...
) engagement. However, it can also be activated by growth factors like IL-7 or
IL-2 The Ilyushin Il-2 (Russian language, Russian: Илью́шин Ил-2) is a Ground attack aircraft, ground-attack plane that was produced by the Soviet Union in large numbers during the World War II, Second World War. The word ''shturmovík'' (C ...
and by metabolites like
glucose Glucose is a simple sugar with the molecular formula . Glucose is overall the most abundant monosaccharide, a subcategory of carbohydrates. Glucose is mainly made by plants and most algae during photosynthesis from water and carbon dioxide, using ...
or
amino acid Amino acids are organic compounds that contain both amino and carboxylic acid functional groups. Although hundreds of amino acids exist in nature, by far the most important are the alpha-amino acids, which comprise proteins. Only 22 alpha am ...
s ( leucin,
arginine Arginine is the amino acid with the formula (H2N)(HN)CN(H)(CH2)3CH(NH2)CO2H. The molecule features a guanidino group appended to a standard amino acid framework. At physiological pH, the carboxylic acid is deprotonated (−CO2−) and both the am ...
or
glutamine Glutamine (symbol Gln or Q) is an α-amino acid that is used in the biosynthesis of proteins. Its side chain is similar to that of glutamic acid, except the carboxylic acid group is replaced by an amide. It is classified as a charge-neutral, ...
). In contrast, there are more gaps as to how mTORC2 pathway functions, but its activation is also achieved through growth factors as exemplified by IL-2. When activated mTORC1 negatively regulates autophagy (through inhibiting the
ULK The German language satirical magazine ''Ulk'' was printed from 1872 until 1933 by the publisher Rudolf Mosse. Its headquarters was in Berlin, Germany. Initially it was an independent weekly paper as ''Wochenblatt für Humor und Satire''. It ...
complex) and shifts the cell towards aerobic glycolysis,
glutaminolysis Glutaminolysis (''glutamine'' + '' -lysis'') is a series of biochemical reactions by which the amino acid glutamine is lysed to glutamate, aspartate, CO2, pyruvate, lactate, alanine and citrate. The glutaminolytic pathway Glutaminolysis partia ...
(through activation of
c-Myc ''Myc'' is a family of regulator genes and proto-oncogenes that code for transcription factors. The ''Myc'' family consists of three related human genes: ''c-myc'' (MYC), ''l-myc'' (MYCL), and ''n-myc'' (MYCN). ''c-myc'' (also sometimes referre ...
) and promotes
lipid synthesis Lipid metabolism is the synthesis and degradation of lipids in cells, involving the breakdown or storage of fats for energy and the synthesis of structural and functional lipids, such as those involved in the construction of cell membranes. In anim ...
and mitochondrial remodelling. mTORC2 enhances glycolysis as well, but in contrast to mTORC1, it activates akt, which in turn promotes glucose transporter 1 (
GLUT1 Glucose transporter 1 (or GLUT1), also known as solute carrier family 2, facilitated glucose transporter member 1 (SLC2A1), is a uniporter protein that in humans is encoded by the ''SLC2A1'' gene. GLUT1 facilitates the transport of glucose across ...
) membrane deposition. It also further promotes, through other kinases, cell proliferation and survival.


PI3K-akt

PI3K mediates the phosphorylation of phosphatidylinositol-(4,5)-bisphosphate (
PIP2 Phosphatidylinositol 4,5-bisphosphate or PtdIns(4,5)''P''2, also known simply as PIP2 or PI(4,5)P2, is a minor phospholipid component of cell membranes. PtdIns(4,5)''P''2 is enriched at the plasma membrane where it is a substrate for a number of ...
) into phosphatidylinositol-(3,4,5)-trisphosphate (
PIP3 Phosphatidylinositol (3,4,5)-trisphosphate (PtdIns(3,4,5)''P''3), abbreviated PIP3, is the product of the class I phosphoinositide 3-kinases (PI 3-kinases) phosphorylation of phosphatidylinositol (4,5)-bisphosphate (PIP2). It is a phospholipid th ...
). PIP3 then serves as a scaffold for other proteins, which contain a pleckstrin homology ( PH) domain. It can be activated, just like mTOR, through TCR, CD28 and, unlike mTOR, through another costimulatory molecule: Inducible T-cell COStimulator (
ICOS Icos Corporation (trademark ICOS) was an American biotechnology company and the largest biotechnology company in the U.S. state of Washington, before it was sold to Eli Lilly and Company in 2007. It was founded in 1989 by David Blech, Isaac ...
). The present of PIP3 on a membrane recruits many proteins including phosphoinositide-dependent protein kinase 1 (
PDK1 Pyruvate dehydrogenase lipoamide kinase isozyme 1, mitochondrial is an enzyme that in humans is encoded by the ''PDK1'' gene. It codes for an isozyme of pyruvate dehydrogenase kinase (PDK). Pyruvate dehydrogenase (PDH) is a part of a mitochondri ...
), which after its phosphorylation together with mTORC2 activates akt, a serine/threonine kinase. As a result akt promotes GLUT1 membrane deposition and akt also inhibits
transcription factor In molecular biology, a transcription factor (TF) (or sequence-specific DNA-binding factor) is a protein that controls the rate of transcription of genetic information from DNA to messenger RNA, by binding to a specific DNA sequence. The fu ...
forkhead box O (FoxO), whose inactivation acts in synergy with the mTORC2 above mentioned changes.


LBK1-AMPK

Both LBK1 and AMPK are serine/threonine kinases acting predominantly opposingly to the aforementioned molecules. From the two, LBK1's activation is less understood, as it is mainly dependants on cellular localization and on many posttranslational modifications. For instance the above-mentioned akt can stimulate LBK1 inhibition through promoting nuclear retention. When activated, LBK1 can activate, apart from other targets, AMPK, whose activation leads to mTORC1 destabilization. Furthermore, it activates ULK complex, phosphorylates
p53 p53, also known as Tumor protein P53, cellular tumor antigen p53 (UniProt name), or transformation-related protein 53 (TRP53) is a regulatory protein that is often mutated in human cancers. The p53 proteins (originally thought to be, and often s ...
and acetyl-CoA carboxylase (
ACC ACC most often refers to: * Atlantic Coast Conference, an NCAA Division I collegiate athletic conference located in the US *American College of Cardiology, A US-based nonprofit medical association that bestows credentials upon cardiovascular spec ...
), which promotes autophagy, cell cycle arrest and fatty acids oxidation respectively. Since AMPK can also be activated through adenosine monophosphate (
AMP #REDIRECT Amp {{Redirect category shell, {{R from other capitalisation{{R from ambiguous page ...
) or by glucose insufficiency, it acts as a sensor of starvation and therefore activates many already mentioned catabolic processes, which is in direct contrast with mTOR, which activates myriad of anabolic processes.


Immune cells

Generally speaking, cells, whose primary objective is their long-term survival or control of inflammation, in terms of energy tend to rely on Krebs cycle and lipid oxidation which are both coupled with functional oxidative phosphorylation. Among these cells we can include
naive T cell In immunology, a naive T cell (Th0 cell) is a T cell that has differentiated in the thymus, and successfully undergone the positive and negative processes of central selection in the thymus. Among these are the naive forms of helper T cells ( CD ...
s,
memory T cell Memory T cells are a subset of T lymphocytes that might have some of the same functions as memory B cells. Their lineage is unclear. Function Antigen-specific memory T cells specific to viruses or other microbial molecules can be found in both ...
s, regulatory T cells ( Tregs), unstimulated innate immune cells like
macrophage Macrophages (abbreviated as M φ, MΦ or MP) ( el, large eaters, from Greek ''μακρός'' (') = large, ''φαγεῖν'' (') = to eat) are a type of white blood cell of the immune system that engulfs and digests pathogens, such as cancer cel ...
s and
M2 macrophage Macrophages (abbreviated as M φ, MΦ or MP) ( el, large eaters, from Greek ''μακρός'' (') = large, ''φαγεῖν'' (') = to eat) are a type of white blood cell of the immune system that engulfs and digests pathogens, such as cancer cel ...
s. On the contrary, cells whose main function is proliferation, synthesis of different molecules or propagation of inflammation often prefer glycolysis as a source of energy and metabolites. Therefore, into these cells belong for instance
effector T cells The T helper cells (Th cells), also known as CD4+ cells or CD4-positive cells, are a type of T cell that play an important role in the adaptive immune system. They aid the activity of other immune cells by releasing cytokines. They are consider ...
and M1 macrophages.


T cells

Naive T cells have to be kept in a permanent state of quiescence, until they encounter their cognate
antigen In immunology, an antigen (Ag) is a molecule or molecular structure or any foreign particulate matter or a pollen grain that can bind to a specific antibody or T-cell receptor. The presence of antigens in the body may trigger an immune response. ...
. The quiescence state is sustained by tonic TCR signalling and by IL-7. Tonic TCR signalling is necessary to keep the FoxO transcription factor active, which in turn allows for IL-7R transcription. This enables the T cell to survive and proliferate at a low rate. However, during this tonic TCR signalling proteins, that control metabolism, have to be strictly regulated, because their activation could lead to spontaneous exit of quiescence and differentiation into various T cells subset, as exemplified by the uncontrolled activation of PI3K which causes the development of Th1 or Th2. Both of the aforementioned signals should lead to the mTOR and akt activation, but in quiescence T cells there are tuberous sclerosis complex (
TSC TSC may refer to: Organizations * Technology Service Corporation, a US engineering company * Terrorist Screening Center, a division of the National Security Branch of the US Federal Bureau of Investigation * The Shopping Channel, a Canadian televi ...
) and phosphatase and tensin homolog ( PTEN) acting against their activations. Therefore, a naive T cell dependent predominantly on oxidative phosphorylation and has much lower glucose uptake and ATP production than their activated counterparts (effector T cells). Quiescence exit begins when a T cell encounters its cognate antigen usually during an infection. The TCR signal together with the costimulation signal lead to downregulation of PTEN and TSC. This causes the phosphorylation cascades of mTOR and akt and many more kinases to be fully activated. These cascades activities result in glucose and glutamine uptake coupled with higher glycolysis and glutaminolysis, which not only supports rapid cell growth, but also further promotes mTOR activation. Furthermore, mTOR stimulates lipid synthesis and mitochondria remodelling, exemplified by increased expression of sterol regulatory element-binding protein (
SREBP Sterol regulatory element-binding proteins (SREBPs) are transcription factors that bind to the sterol regulatory element DNA sequence TCACNCCAC. Mammalian SREBPs are encoded by the genes '' SREBF1'' and ''SREBF2''. SREBPs belong to the basic- ...
) and mitochondria undergoing fission, which causes them to function predominantly as biosynthetic hubs, rather than energy production hubs. After their activation and the metabolic reprogramming, T cells compete with one another and consequently, it is very likely that during its effector phase T cells reach a point, where they suffer from lack of nutrients. In such cases AMPK is activated to balance the mTOR signalling and to prevent apoptosis. The described scheme of quiescence exit holds true for inflammatory T cells subsets like Th1, Th2,
Th17 T helper 17 cells (Th17) are a subset of pro-inflammatory T helper cells defined by their production of interleukin 17 (IL-17). They are related to T regulatory cells and the signals that cause Th17s to differentiate actually inhibit Treg different ...
and
cytotoxic T cell A cytotoxic T cell (also known as TC, cytotoxic T lymphocyte, CTL, T-killer cell, cytolytic T cell, CD8+ T-cell or killer T cell) is a T lymphocyte (a type of white blood cell) that kills cancer cells, cells that are infected by intracellular pa ...
s. However, mTOR activity can be detrimental when we focus on Tregs. This is shown by the fact that in Tregs high activation of mTORC1 coupled with a higher level of glycolysis leads to the failure of Treg lineage commitment. Therefore, in contrast to inflammatory cell subsets, Tregs rely on oxidative phosphorylation fuelled by lipid oxidation. Although, it is important to note that complete suppression of glycolysis leads to
enolase Phosphopyruvate hydratase, usually known as enolase, is a metalloenzyme () that catalyses the conversion of 2-phosphoglycerate (2-PG) to phosphoenolpyruvate (PEP), the ninth and penultimate step of glycolysis. The chemical reaction is: :2-p ...
(a glycolytic enzyme) binding to a
splice variant Alternative splicing, or alternative RNA splicing, or differential splicing, is an alternative splicing process during gene expression that allows a single gene to code for multiple proteins. In this process, particular exons of a gene may be in ...
of Foxp3, which effectively compromises peripheral Tregs abilities to act as immunosuppressive cells. After the infection is cleared most of the activated T cells succumb to
apoptosis Apoptosis (from grc, ἀπόπτωσις, apóptōsis, 'falling off') is a form of programmed cell death that occurs in multicellular organisms. Biochemical events lead to characteristic cell changes (morphology) and death. These changes incl ...
. However, few of them survive and develop into the memory T cell subsets. For this development the engagement of costimulatory molecules, like CD28, appears to be crucial, as the co-stimulation manifests in mitochondrial morphology, thus allowing for higher oxidative phosphorylation but also retaining the potential to quickly revert to glycolysis. Moreover, T cell activation causes an overall increase in acetyl-CoA, which is a substrate for the histone acetylation. As a results, many genes are acetylated and therefore accessible to transcription even after the differentiation into memory subsets, hence allowing memory T cells to rapidly re-express some effector related genes. The aforementioned changes allow T cells to become memory cells, but what exactly drives the memory cell differentiation is still under debate, even though IL-15 seems to be necessary for the T cell memory induction. Recently, asymmetric division of mTORC1, during the first divisions after TCR activation, has been shown to drive the memory cell differentiation in those cells which receive lower amount of mTORC1.


Macrophages

Immunometabolism of macrophages is mostly studied in the two opposing populations of macrophages: M1 and M2. M1 macrophages are a pro-inflammatory population induced by LPS or
IFNγ Interferon gamma (IFN-γ) is a dimerized soluble cytokine that is the only member of the type II class of interferons. The existence of this interferon, which early in its history was known as immune interferon, was described by E. F. Wheelock ...
. This activation leads, as in the case of T cells, to increase in glycose uptake and glycolysis. What is strikingly different is the Krebs cycle, as in the case of M1 macrophages the cycle is broken at two places. The first break is the conversion of iso-citrate to α-ketoglutarate owing to the downregulation of
isocitrate dehydrogenase Isocitrate dehydrogenase (IDH) () and () is an enzyme that catalyzes the oxidative decarboxylation of isocitrate, producing alpha-ketoglutarate (α-ketoglutarate) and CO2. This is a two-step process, which involves oxidation of isocitrate (a s ...
. Accumulated citrate is subsequently used for lipid and itaconate synthesis, which are both indispensable for M1 macrophages function. The second break at the succinate to fumarate transition occurs probably due to the itaconate production and causes a build up of succinate. This triggers ROS production, which stabilizes HIF-1α. This transcription factor further promotes glycolysis and it is essential for activation of inflammatory macrophages. M2 macrophages are anti-inflammatory cells which need for their induction IL-4. M2 macrophages metabolism is markedly distinct from M1 macrophages due to their unbroken Krebs cycle, which after their activation is fuelled by upragulated glycolysis, glutaminolysis and fatty acid oxidation. How the fully operational Krebs cycle exactly translates to M2 macrophages functions is still poorly understood, but the upregulated pathways allow for production of intermediates (mainly
acetyl-CoA Acetyl-CoA (acetyl coenzyme A) is a molecule that participates in many biochemical reactions in protein, carbohydrate and lipid metabolism. Its main function is to deliver the acetyl group to the citric acid cycle (Krebs cycle) to be oxidized for ...
and
S-adenosyl methionine ''S''-Adenosyl methionine (SAM), also known under the commercial names of SAMe, SAM-e, or AdoMet, is a common cosubstrate involved in methyl group transfers, transsulfuration, and aminopropylation. Although these anabolic reactions occur throug ...
), which are needed for
histone In biology, histones are highly basic proteins abundant in lysine and arginine residues that are found in eukaryotic cell nuclei. They act as spools around which DNA winds to create structural units called nucleosomes. Nucleosomes in turn are wr ...
modifications of genes targeted by IL-4 signalling.


Drug discovery

Immunometabolism is an area of growing drug discovery research investment in numerous areas of
medicine Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care pract ...
, such as for example, in lessening the impact of age-related metabolic dysfunction and
obesity Obesity is a medical condition, sometimes considered a disease, in which excess body fat has accumulated to such an extent that it may negatively affect health. People are classified as obese when their body mass index (BMI)—a person's we ...
on incidence of
type 2 diabetes Type 2 diabetes, formerly known as adult-onset diabetes, is a form of diabetes mellitus that is characterized by high blood sugar, insulin resistance, and relative lack of insulin. Common symptoms include increased thirst, frequent urination, ...
/
cardiovascular disease Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels. CVD includes coronary artery diseases (CAD) such as angina and myocardial infarction (commonly known as a heart attack). Other CVDs include stroke, h ...
,
cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...
, as well as infectious diseases. In recent years, evidence suggests that immunometabolism is implicated in autoimmune disorders. The metabolic alterations on immune system regulation have provided unique insights into disease pathogenesis and development, as well as potential therapeutic targets.


References


External links

*{{citation , url=https://www.nature.com/collections/jebijhebde , title=Focus on immunometabolism , work=
Nature Nature, in the broadest sense, is the physics, physical world or universe. "Nature" can refer to the phenomenon, phenomena of the physical world, and also to life in general. The study of nature is a large, if not the only, part of science. ...
Metabolism Immunology