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Ketone BHB eases colitis via STAT6-driven M2 macrophages

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IBD mucosa has lower β-hydroxybutyrate; giving BHB reduces DSS colitis severity by promoting STAT6-dependent M2 macrophage programs and mucosal repair.

Source

Ketone body β-hydroxybutyrate ameliorates colitis by promoting M2 macrophage polarization through the STAT6-dependent signaling pathway

Huang C, Wang J, Liu H, et al. · BMC medicine · 2022

doi.org/10.1186/s12916-022-02352-xRead the full paper ↗150 citationscc by

What they did

Huang et al. measured BHB in IBD vs control colonic mucosa, treated DSS colitis mice with exogenous BHB (assessing weight, DAI, colon length, histology), profiled M2 genes/microbes, and tested BMDMs with IL-4 ± 5 mM BHB and STAT6 inhibitor AS1517499.

What they found

Mucosal BHB was reduced and tracked IBD activity. Exogenous BHB lessened weight loss, DAI, shortening, and epithelial damage while raising M2 genes (IL-4Ra, IL-10, Arg-1, Chil3). BHB boosted STAT6 phosphorylation and M2 programs in vitro; AS1517499 blocked anti-inflammatory/repair benefits.

The limits

What it doesn't show

Human data are observational for BHB levels; mouse DSS is acute, not chronic human IBD. Clinical ketone therapy safety/efficacy remain untested here.

Key terms

β-hydroxybutyrate (BHB)
Ketone body used as fuel and signaling metabolite.
DSS colitis
Dextran sulfate sodium mouse model of acute intestinal inflammation.
M2 macrophage
Alternatively activated macrophage associated with repair/anti-inflammation.
STAT6
Transcription factor downstream of IL-4/IL-13 required for BHB’s M2 effect here.
AS1517499
STAT6 inhibitor that abolishes BHB’s protective effects.
DAI
Disease activity index scoring colitis severity.

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BHB levels in IBD colonic mucosa are…

Common questions

Is BHB altered in human IBD tissue?

Yes—colonic mucosal BHB is significantly reduced and correlates with activity.

Does giving BHB help DSS colitis?

Yes—less weight loss, lower DAI, less shortening/histology damage.

What macrophage program is promoted?

M2-associated genes (IL-4Ra, IL-10, Arg-1, Chil3) via STAT6.

What blocks BHB’s benefit?

STAT6 inhibitor AS1517499 completely inhibits the protective effects.

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