Ketone bodies, potential therapeutic uses.
Level 5 - mechanism / opinion, no new human data
Narrative review describing mechanistic and preclinical concepts with no new human data.
PubMed 11569918 · doi:10.1080/152165401753311780
What was done
This narrative review examined the biochemical mechanisms and potential clinical utility of ketosis, specifically elevation of D-beta-hydroxybutyrate (betaOHB) and acetoacetate. The abstract discusses findings from cellular and preclinical models, including isolated perfused rat hearts, sperm, and human neuronal cell culture models of Alzheimer's and Parkinson's disease, as well as the delivery requirements for oral synthetic ketone esters or polymers.
What was found
The abstract reports no clinical trial data or quantitative effect sizes. It reports that betaOHB improves metabolic efficiency per unit of oxygen in isolated rat heart and sperm models, reduces cell death in Alzheimer's and Parkinson's human neuronal culture models, increases the free energy of ATP hydrolysis, and alters redox couples (oxidizing co-enzyme Q and reducing NADP+) to reduce free radical damage. To achieve therapeutic blood concentrations of 2 to 5 mmol/L, oral ingestion of 100 to 150 g or more daily of synthetic esters or polymers was estimated to be necessary.
Why it matters
The paper synthesizes the bioenergetic rationale for using exogenous ketone bodies as therapeutic agents in neurodegenerative diseases, epilepsy, and hypoxic injury.
Limits
The abstract describes only theoretical mechanisms, in vitro cell cultures, and ex vivo animal tissue models without presenting primary human clinical trial data. No patient sample sizes, randomized comparisons, safety profiles, or clinical outcome metrics are reported.
Cited by
- supports Lactate and ketone bodies are thermodynamically favorable energy sources that require less oxygen and fewer ATP molecules to produce energy.