Microbial Imidazole Propionate Affects Responses to Metformin through p38γ-Dependent Inhibitory AMPK Phosphorylation

Research output: Contribution to journalJournal articleResearchpeer-review

  • Ara Koh
  • Louise Manneras-Holm
  • Na-Oh Yunn
  • Peter M. Nilsson
  • Sung Ho Ryu
  • Antonio Molinaro
  • Rosie Perkins
  • J. Gustav Smith
  • Fredrik Backhed

Metformin is the first-line therapy for type 2 diabetes, but there are large inter-individual variations in responses to this drug. Its mechanism of action is not fully understood, but activation of AMP-activated protein kinase (AMPK) and changes in the gut microbiota appear to be important. The inhibitory role of microbial metabolites on metformin action has not previously been investigated. Here, we show that concentrations of the microbial metabolite imidazole propionate are higher in subjects with type 2 diabetes taking metformin who have high blood glucose. We also show that metformin-induced glucose lowering is not observed in mice pretreated with imidazole propionate. Furthermore, we demonstrate that imidazole propionate inhibits AMPK activity by inducing inhibitory AMPK phosphorylation, which is dependent on imidazole propionate-induced basal Akt activation. Finally, we identify imidazole propionate-activated p38 gamma as a novel kinase for Akt and demonstrate that p38 gamma kinase activity mediates the inhibitory action of imidazole propionate on metformin.

Original languageEnglish
JournalCell Metabolism
Volume32
Issue number4
Pages (from-to)643-653.e4
Number of pages15
ISSN1550-4131
DOIs
Publication statusPublished - 2020

    Research areas

  • ACTIVATED PROTEIN-KINASE, SKELETAL-MUSCLE, INSULIN-RESISTANCE, AKT, SULFASALAZINE, INACTIVATION, CHEMOTHERAPY, INCREASES, MECHANISM, MTORC1

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