Why a d-?-hydroxybutyrate monoester?
Ontology highlight
ABSTRACT: Much of the world's prominent and burdensome chronic diseases, such as diabetes, Alzheimer's, and heart disease, are caused by impaired metabolism. By acting as both an efficient fuel and a powerful signalling molecule, the natural ketone body, d-?-hydroxybutyrate (?HB), may help circumvent the metabolic malfunctions that aggravate some diseases. Historically, dietary interventions that elevate ?HB production by the liver, such as high-fat diets and partial starvation, have been used to treat chronic disease with varying degrees of success, owing to the potential downsides of such diets. The recent development of an ingestible ?HB monoester provides a new tool to quickly and accurately raise blood ketone concentration, opening a myriad of potential health applications. The ?HB monoester is a salt-free ?HB precursor that yields only the biologically active d-isoform of the metabolite, the pharmacokinetics of which have been studied, as has safety for human consumption in athletes and healthy volunteers. This review describes fundamental concepts of endogenous and exogenous ketone body metabolism, the differences between the ?HB monoester and other exogenous ketones and summarises the disease-specific biochemical and physiological rationales behind its clinical use in diabetes, neurodegenerative diseases, heart failure, sepsis related muscle atrophy, migraine, and epilepsy. We also address the limitations of using the ?HB monoester as an adjunctive nutritional therapy and areas of uncertainty that could guide future research.
SUBMITTER: Soto-Mota A
PROVIDER: S-EPMC7065286 | biostudies-literature | 2020 Feb
REPOSITORIES: biostudies-literature
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