Abstract

ObjectiveObese and/or diabetic patients have elevated levels of free fatty acids and increased susceptibility to gastrointestinal symptoms. Since the enteric nervous system is pivotal in regulating gastrointestinal functions alterations or neuropathy in the enteric neurons are suspected to occur in these conditions. Lipid induced intestinal changes, in particular on enteric neurons, were investigated in vitro and in vivo using primary cell culture and a high fat diet (HFD) mouse model.DesignMice were fed normal or HFD for 6 months. Intestines were analyzed for neuronal numbers, remodeling and lipid accumulation. Co-cultures of myenteric neurons, glia and muscle cells from rat small intestine, were treated with palmitic acid (PA) (0 – 10−3 M) and / or oleic acid (OA) (0 – 10−3 M), with or without modulators of intracellular lipid metabolism. Analyses were by immunocyto- and histochemistry.ResultsHFD caused substantial loss of myenteric neurons, leaving submucous neurons unaffected, and intramuscular lipid accumulation in ileum and colon. PA exposure in vitro resulted in neuronal shrinkage, chromatin condensation and a significant and concentration-dependent decrease in neuronal survival; OA exposure was neuroprotective. Carnitine palmitoyltransferase 1 inhibition, L-carnitine- or alpha lipoic acid supplementation all counteracted PA-induced neuronal loss. PA or OA alone both caused a significant and concentration-dependent loss of muscle cells in vitro. Simultaneous exposure of PA and OA promoted survival of muscle cells and increased intramuscular lipid droplet accumulation. PA exposure transformed glia from a stellate to a rounded phenotype but had no effect on their survival.ConclusionsHFD and PA exposure are detrimental to myenteric neurons. Present results indicate excessive palmitoylcarnitine formation and exhausted L-carnitine stores leading to energy depletion, attenuated acetylcholine synthesis and oxidative stress to be main mechanisms behind PA-induced neuronal loss.High PA exposure is suggested to be a factor in causing diabetic neuropathy and gastrointestinal dysregulation.

Highlights

  • Obese and/or diabetic patients face an increased risk of multiple complications and decreased quality of life.[1]

  • high fat diet (HFD) and palmitic acid (PA) exposure are detrimental to myenteric neurons

  • Present results indicate excessive palmitoylcarnitine formation and exhausted L-carnitine stores leading to energy depletion, attenuated acetylcholine synthesis and oxidative stress to be main mechanisms behind PA-induced neuronal loss.High PA exposure is suggested to be a factor in causing diabetic neuropathy and gastrointestinal dysregulation

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Summary

Introduction

Obese and/or diabetic patients face an increased risk of multiple complications and decreased quality of life.[1] In a population based survey more than 75% of diabetic patients report gastrointestinal (GI) symptoms.[2] The basis for optimal GI regulation is the enteric nervous system (ENS) innervating the entire digestive tract, and pivotal in coordinating motility, secretion and blood flow. A patients metabolic and nutritional status contribute to the development of type 2 diabetes (T2D) and obesity is considered the single largest risk factor.[1] The lipid profile in obese and type 2diabetic patients is characterized by elevated plasma levels of the saturated free fatty acid (FFA) palmitic acid (PA,16:0) and the monounsaturated FFA oleic acid (OA,18:1).[3] Lipotoxicity is induced by prolonged exposures to an excess of FFA, PA. Its hallmarks are lipid accumulation in nonadipose tissues, cellular dysfunction and apoptosis.[4,5] Lipid-induced ENS neuropathy and subsequent pathophysiological signs of GI dysfunction are scarcely studied

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