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Studies highlight impaired ketone production as a potential confounder of severe COVID-19




In severely ill Covid-19 patients, metabolism produces inadequate amounts of certain energy-rich compounds called ketone bodies. However, these energy carriers are required for two important cell types of the immune system to effectively fight the virus. Perhaps this finding explains why some people get a much more serious illness than others. Studies led by the University of Bonn and the University of Bonn Hospital point at least in this direction. The results are currently published in the journal Nature. They also give hope for new treatments.

When you get sick, you often lose your appetite. This also affects our metabolism. The carbs aren’t being supplied enough, so it switches to burning fat. This creates energy-rich molecules called ketone bodies. And these may help our body cope with the virus well.

At least that’s what the results of current research suggest. “We have found that patients with influenza infections produce significant amounts of ketone bodies,” explains Dr. Christoph Wilhelm, Institute of Clinical Chemistry and Clinical Pharmacology at the University of Bonn Hospital. University of Bonn. “In contrast, there was little increase in Covid-19 patients, at least in patients with a moderate or severe course.”

In addition, it was impressive that people infected with the coronavirus had low levels of inflammatory messenger in their blood. This was especially true for interferon gamma. It is a cytokine secreted by T helper cells, a specific group of immune cells. These cells use it to call the help of phagocytes and other defense forces of the immune system to fight the virus.However, in order to generate IFN-γ efficiently, helpers T cells Obviously a proper supply of ketone bodies is needed. If this is lacking, they will produce less interferon gamma. In addition, helper T cells die faster.

Ketone bodies make the immune system stronger

Researchers have also seen similar effects on killer T cells, another important group of immune cells.

They also need ketone bodies to work well and effectively eliminate the virus. “

Dr. Christian Bode, Lecturer, Department of Anesthesiology and Surgery Intensive Care Medicine, University of Bonn Hospital

Apparently, ketone bodies promote mitochondrial function, and metabolic power fuels immune cells. This not only improves energy production, but also provides the molecules needed for interferon production.

“On the other hand, killer T cells and helper T cells show signs of depletion if they are not adequately supplied with ketone bodies,” Bode explains. “In this depleted state, they can no longer perform their functions properly.” However, researchers either put sick mice in a ketogenic diet (a diet low in carbohydrates and protein) or By directly administering ketone bodies, immune cells could be revived. The animals then succeeded in removing the virus and significantly reduced lung damage.

Expect new treatment options

Therefore, this result also raises expectations for new treatment options. “By targeting and changing your diet, you may be able to increase your body’s defenses,” Wilhelm says. “Future studies must show whether this really works.” Researchers clearly advise against self-experimentation with dietary supplements and diets. These can be more harmful than good.

The new findings may also be related to other infectious diseases. In the medium term, they may even contribute to new strategies to help the body fight tumors.

Participating institutions and funds:

In addition to the University Hospital and the University of Bonn, the University of Braunschweig and the University Hospitals of Hanover, Zurich, Naimegen and Essen participated in the study. This study was funded by the German Research Foundation (DFG), the Federal Ministry of Education and Research (BMBF), the European Research Council (ERC), and the Dutch Institute for Scientific Research (NWO).


Journal reference:

Karagiannis, F., et al. (2022) Impaired ketone production links metabolism to T cell dysfunction of COVID-19. Nature..




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