Fructose in the kidney: from physiology to pathology
- 주제(키워드) Fructose , Glycolysis , Inflammation , Mitochondria , Proximal tubules , Uric acid , Warburg effect
- 주제(기타) Urology & Nephrology
- 설명문(일반) [Nakagawa, Takahiko] Rakuwakai Otowa Hosp, Dept Nephrol, Kyoto, Japan; [Kang, Duk-Hee] Ewha Womans Univ, Ewha Med Res Inst, Div Nephrol, Dept Internal Med,Coll Med, Seoul, South Korea
- 등재 SCIE, SCOPUS, KCI등재
- OA유형 Green Published, gold
- 발행기관 KOREAN SOC NEPHROLOGY
- 발행년도 2021
- 총서유형 Journal
- URI http://www.dcollection.net/handler/ewha/000000190776
- 본문언어 영어
- Published As https://doi.org/10.23876/j.krcp.21.138
- PubMed https://pubmed.ncbi.nlm.nih.gov/34781638
초록/요약
The Warburg effect is a unique property of cancer cells, in which glycolysis is activated instead of mitochondrial respiration despite oxygen availability. However, recent studies found that the Warburg effect also mediates non-cancer disorders, including kidney disease. Currently, diabetes or glucose has been postulated to mediate the Warburg effect in the kidney, but it is of importance that the Warburg effect can be induced under nondiabetic conditions. Fructose is endogenously produced in several organs, including the kidney, under both physiological and pathological conditions. In the kidney, fructose is predominantly metabolized in the proximal tubules; under normal physiologic conditions, fructose is utilized as a substrate for gluconeogenesis and contributes to maintain systemic glucose concentration under starvation conditions. However, when present in excess, fructose likely becomes deleterious, possibly due in part to excessive uric acid, which is a by-product of fructose metabolism. A potential mechanism is that uric acid suppresses aconitase in the Krebs cycle and therefore reduces mitochondrial oxidation. Consequently, fructose favors glycolysis over mitochondrial respiration, a process that is similar to the Warburg effect in cancer cells. Activation of glycolysis also links to several side pathways, including the pentose phosphate pathway, hexosamine pathway, and lipid synthesis, to provide biosynthetic precursors as fuel for renal inflammation and fibrosis. We now hypothesize that fructose could be the mediator for the Warburg effect in the kidney and a potential mechanism for chronic kidney disease.
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