All cells, including those involved in immune responses, depend on nutrient availability to maintain their functionality
[37]. When there is an inflammatory or antigenic cue, immune cells need more amino acids to remain viable and respond accordingly, so they must adapt rapidly to any shortage of amino acids
[38]. This adaptation suggests that any modification in amino acid (and other nutrient) metabolism will also affect the immune response in different ways, depending on the specific nutrient and energy requirements of the cells and, thus, their function
[39][40]. In other words, each immune cell’s microenvironment will be directly related to their response to nutrient availability. Both the innate and adaptive immune systems require an adequate supply of amino acids to synthesize molecules such as histamine, glutathione, and nitric oxide, among others, but especially for immunoglobulins and cytokine activation, as well as for antibody production through mTOR signaling by BCAA
[41]. Therefore, individual amino acids and their metabolites can affect immune responses.
4.2. Amino Acid Catabolism in Obesity and Diabetes
An adequate amino acid catabolism is crucial to maintaining plasma amino acid concentration. Disturbances in plasma amino acid concentration have been associated with alterations in individual health
[36]. In a cross-sectional study with young adults, it has been observed that subjects with obesity have higher levels of alanine, aspartate, cysteine, ornithine, phenylalanine, proline, and tyrosine and lower levels of glycine, ornithine, and serine compared to normal weight subjects
[43]. Furthermore, subjects with insulin resistance (IR) (defined as HOMA > 2.5) have higher levels of arginine, alanine, aspartate, isoleucine, leucine, phenylalanine, proline, tyrosine, taurine, and valine than subjects without IR
[43]. In addition, increased levels of BCAA and aromatic amino acids are associated with a five-fold increased risk of developing type 2 diabetes
[44][45]. BCAAs play important general roles in the body, including regulation of protein synthesis through mTOR and as a source of energy during exercise, which have been extensively reviewed elsewhere
[46]. However, there is significant controversy as to whether altered plasma concentrations of amino acids, especially BCAA, are a cause or consequence of obesity or insulin resistance. Unlike the rest of the amino acids, as mentioned above, the first enzymatic reaction of BCAA catabolism is extrahepatic, with muscle, kidney, and adipose tissue as the principal organs for BCAA transamination. Notably, BCAA catabolism is mainly impaired in adipose tissue during obesity. Branched-chain aminotransferase 2 (BCAT2), an isoform of BCAT found in mitochondria, and BCKDH activity are reduced in the adipose tissue of mice and rats with genetic or diet-induced obesity
[47][48][49][50]. In subjects with obesity, BCAT2 and BCKDH expression is reduced mainly in visceral adipose tissue
[48][51]. Nevertheless, further research is needed to clarify the mechanisms responsible for the decreased expression and activity of BCAT2 and BCKDH in adipose tissue during obesity.
The alteration of BCAA catabolism has physiological consequences in two aspects. First, leucine is likely the most potent mTORC1 activator among all amino acids. In physiological conditions, mTORC1 activation inhibits autophagy, activates adipogenesis and lipogenesis in white adipose tissue, and inhibits insulin signaling through the inactivation of the insulin receptor substrate 1 (IRS1). Thus, high leucine concentrations could induce an overactivation of mTORC1, leading to insulin resistance and, thus, an increase in glucose levels
[52][53]. The use of rapamycin, a known mTORC1 inhibitor, prevents glucose intolerance induced by a diet high in fat and BCAA
[54].
Furthermore, leucine catabolism contributes 30% to the acetyl-CoA lipogenic pool
[55]. and acetyl-CoA can be converted into malonyl-CoA by acetyl-CoA carboxylase (ACC). Malonyl-CoA is the preferred substrate of fatty acid synthase (FAS). Thus, leucine is extensively incorporated into the lipid fraction of functional adipocytes. Incorporation that is significantly reduced in adipocytes from high-fat fed rats
[49]. In addition to fatty acids, the carbon skeleton of leucine could be a substrate for synthesizing phospholipids and cholesterol. An increase in cholesterol-synthetizing enzymes has been demonstrated, which use 3-hydroxy-3-methylglutaryl-CoA, an intermediate of leucine catabolism, as a substrate during adipogenesis
[56]. Taken together, this evidence suggests that decreased catabolism of BCAA could reduce the production and storage of FA and cholesterol in adipose tissue, affecting its functionality.
Second, a reduction in the BCAA catabolic enzymes causes an inefficient production of anaplerotic substrates from BCAA, causing suboptimal activity of the Krebs cycle
[57][58]. These results have important implications for the understanding of metabolic inflexibility. Until now, metabolic flexibility has only been assessed in terms of how glucose affects lipid metabolism and vice versa. However, new evidence suggests that amino acid catabolism needs to be evaluated in terms of metabolic flexibility because amino acid availability and catabolic amino acid metabolites can also affect lipid and carbohydrate metabolism, as in the model proposed by Muoio, where chronic overfeeding causes a mitochondrial blockade affecting glucose, fatty acid, and BCAA oxidation
[59].
Although progress has been made in understanding the participation of BCAA catabolism in the maintenance of adipocyte function, further research is needed to understand the role of catabolism of other amino acids such as aspartate, proline, tyrosine, and tryptophan, among others, that can modify mitochondrial activity and therefore metabolic flexibility in the adipocyte.
In addition to BCAAs, tryptophan (Trp) is another essential amino acid for humans,
[60]. Consumed tryptophan is mainly used for protein synthesis; however, this amino acid can be used in about 5% of cases as a precursor for the synthesis of serotonin, N-acetyl serotonin, and melatonin
[61]. Interestingly, a part of free tryptophan is also catabolized through the tryptophan-kynurenine pathway
[62]. Recent studies have found that certain metabolites of tryptophan catabolism participate in the development of T2D
[63]. A significant association between low plasma Trp concentrations has been reported in obese subjects with metabolic syndrome, in whom insulin resistance is common
[64]. Evidence suggests that metabolites of the kynurenine pathway increase with insulin resistance before the clinical manifestation of hyperglycemia
[65]. Gene expression of tryptophan catabolism limiting enzymes to kynurenine, such as indolamine 2,3-dioxygenase 1 (IDO1), indolamine 2,3-dioxygenase 2 (IDO2), and tryptophan 2,3-dioxygenase (TDO2), is shown to increase in patients with T2D
[66]. A possible mechanism by which metabolites of the Trp-Kynurenine pathway contribute to the development of insulin resistance includes the possible formation of chelate complexes between xanthurenic acid and insulin, which are indistinguishable from free insulin but have ∼50% less activity than insulin
[67]. However, studies are still needed to determine the importance of the regulation of gene expression by the step-limiting enzyme of the Trp- Kynurenine pathway in the pathogenesis of diabetes or its complications. On the other hand, Trp and phenylalanine interact with the GPR142 receptor, increasing insulin secretion and the incretins GIP and GLP-1, improving circulating glucose levels
[68], suggesting that the decrease in Trp during obesity will decrease insulin secretion and contribute to the progression to T2D of subjects with obesity.
4.3. Amino Acid Catabolism and Thermogenesis
In addition to white adipose tissue, it has been demonstrated that BAT may play an essential role in the control of body thermogenesis
[69]. This effect is in part mediated by the presence of the uncoupling protein 1 (UCP1), which can use the proton gradient generated in the mitochondria by the respiratory chain in order to produce heat
[70]. The energy sources used by BAT mitochondria are fatty acids and glucose
[71]. Interestingly, recent evidence has demonstrated that BAT mitochondria can use BCAA amino acids as an energy source to increase thermogenesis. BAT is now known to express enzymes of the amino acid catabolic pathways for BCAA, including BCAT2 and BCKDH. Under conditions of cold exposure, where thermogenesis is upregulated, there is a significantly increased uptake of BCAA by BAT, particularly valine and leucine. The importance of BCAA oxidation for thermogenesis has been demonstrated since the absence of BCKDH expression in BAT impairs energy homeostasis, especially during cold exposure. BCAA oxidation occurs in the mitochondria, and it is known that BCAAs are transported into the mitochondria by the SLC25A44 transporter. Surprisingly, the deletion of SLC25A44 impairs BAT thermogenesis
[72].
As previously mentioned, white adipose tissue plays an important role in the utilization of BCAAs, which is associated with improving insulin sensitivity. However, now BAT is also considered an essential catabolic organ of these amino acids, decreasing circulating levels of BCAA that are associated with increased insulin sensitivity.