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Niemann, B.* ; Haufs-Brusberg, S.* ; Puetz, L.* ; Feickert, M.* ; Jaeckstein, M.Y.* ; Hoffmann, A. ; Zurkovic, J.* ; Heine, M.* ; Trautmann, E.-M. ; Müller, C.E.* ; Tönjes, A.* ; Schlein, C.* ; Jafari, A.* ; Eltzschig, H.K.* ; Gnad, T.* ; Blüher, M. ; Krahmer, N. ; Kovacs, P.* ; Heeren, J.* ; Pfeifer, A.*

Apoptotic brown adipocytes enhance energy expenditure via extracellular inosine.

Nature 609, 361–368 (2022)

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Brown adipose tissue (BAT) dissipates energy^1,2 and promotes cardio-metabolic health³. Loss of BAT during obesity and aging is a principal hurdle for BAT-centered obesity therapies, but not much is known about BAT apoptosis. Here, untargeted metabolomics demonstrated that apoptotic brown adipocytes release a specific pattern of metabolites with purine metabolites being highly enriched. Interestingly, this apoptotic secretome enhances expression of the thermogenic program in healthy adipocytes. This effect is mediated by the purine inosine which stimulates energy expenditure (EE) in brown adipocytes via the cAMP/protein kinase A signaling pathway. Treatment of mice with inosine increased BAT-dependent EE and induced "browning" of white adipose tissue. Mechanistically, the equilibrative nucleoside transporter 1 (ENT1, SLC29A1) regulates inosine levels in BAT: ENT1-deficiency increases extracellular inosine levels and consequently enhances thermogenic adipocyte differentiation. In mice, pharmacological inhibition of ENT1 as well as global and adipose-specific ablation enhanced BAT activity and counteracted diet-induced obesity, respectively. In human brown adipocytes, knockdown or blockade of ENT1 increased extracellular inosine, which enhanced thermogenic capacity. Conversely, high ENT1 levels correlated with lower expression of the thermogenic marker UCP1 in human adipose tissues. Finally, the Ile216Thr loss of function mutation in human ENT1 was associated with significantly lower BMI and 59% lower odds of obesity for individuals carrying the Thr variant. Our data identify inosine as a metabolite released during apoptosis with "replace me" signaling function that regulates thermogenic fat and counteracts obesity.

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