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Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 J+Intern+Med 2014 ; 276 (6): 543-59 Nephropedia Template TP
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AMP-activated protein kinase: a key regulator of energy balance with many roles in human disease #MMPMID24824502
Hardie DG
J Intern Med 2014[Dec]; 276 (6): 543-59 PMID24824502show ga
The AMP-activated protein kinase (AMPK) is a sensor of cellular energy status that regulates cellular and whole body energy balance. A recent crystal structure has illuminated the complex regulatory mechanisms by which AMP and ADP cause activation of AMPK, involving phosphorylation by the upstream kinase, LKB1. Once activated by falling cellular energy status, AMPK activates catabolic pathways that generate ATP, while inhibiting anabolic pathways and other cellular processes consuming ATP.AMPK is implicated in many human diseases. Mutations in the ?2 subunit cause heart disease due to excessive glycogen storage in cardiac myocytes, leading to ventricular pre-excitation. AMPK-activating drugs reverse many of the metabolic defects associated with insulin resistance, and recent studies suggest that the insulin-sensitizing effects of the widely used anti-diabetic drug, metformin, are mediated by AMPK. The upstream kinase LKB1 is a tumor suppressor, and AMPK may exert many of its anti-tumor effects. AMPK activation promotes the oxidative metabolism typical of quiescent cells, rather than the aerobic glycolysis observed in tumor cells and cells involved in inflammation, explaining in part why AMPK activators have both anti-tumor and anti-inflammatory effects. Salicylate (the major in vivo metabolite of aspirin) activates AMPK, and this could be responsible for at least some of the anti-cancer and anti-inflammatory effects of aspirin. In addition to metformin and salicylates, novel drugs that modulate AMPK are likely to enter clinical trials soon. Finally, AMPK is implicated in viral infection: down-regulation of AMPK during hepatitis C virus infection appears to be essential for efficient viral replication.