Metabolic Messengers: ketone bodies

Prospective molecular targets and therapeutic applications for ketone body metabolism have increased exponentially in the past decade. Initially considered to be restricted in scope as liver-derived alternative fuel sources during periods of carbohydrate restriction or as toxic mediators during diabetic ketotic states, ketogenesis and ketone bodies modulate cellular homeostasis in multiple physiological states through a diversity of mechanisms. Selective signalling functions also complement the metabolic fates of the ketone bodies acetoacetate and d-beta-hydroxybutyrate. Here we discuss recent discoveries revealing the pleiotropic roles of ketone bodies, their endogenous sourcing, signalling mechanisms and impact on target organs, and considerations for when they are either stimulated for endogenous production by diets or pharmacological agents or administered as exogenous wellness-promoting agents. The authors present an overview of the metabolism and pleiotropic actions of ketone bodies, summarizing their endogenous sources, signalling mechanisms and systemic metabolic effects.

Automated summary

The prospective molecular targets and therapeutic applications for ketone body metabolism have significantly increased in the past decade. Ketogenesis and ketone bodies, initially considered to be alternative fuel sources during carbohydrate restriction or toxic mediators during diabetic ketotic states, actually modulate cellular homeostasis through a variety of mechanisms in multiple physiological states. This article presents an overview of the metabolism and pleiotropic actions of ketone bodies, summarizing their endogenous sources, signaling mechanisms, and systemic metabolic effects.