Youm · Nature medicine 2015 · In vitro cell assays and in vivo mouse disease models · n=?

The ketone metabolite β-hydroxybutyrate blocks NLRP3 inflammasome-mediated inflammatory disease.

Cited 2135 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Preclinical in vitro and animal experimental research.

PubMed 25686106 · doi:10.1038/nm.3804 · record verified 2026-08-29

What was done

Researchers investigated the effects of β-hydroxybutyrate (BHB), acetoacetate, and related short-chain fatty acids on inflammasome activation triggered by urate crystals, ATP, and lipotoxic fatty acids. They tested pathway specificity across NLRP3, NLRC4, AIM2, and caspase-11 inflammasomes, and explored mechanisms including potassium efflux, ASC oligomerization, metabolic pathways, and receptor signaling. Findings were evaluated in human monocytes in vitro and in mouse models of Muckle-Wells syndrome, familial cold autoinflammatory syndrome, and urate crystal-induced peritonitis using BHB administration and ketogenic diets.

What was found

The abstract reports no quantitative values, percentages, or sample sizes. Qualitatively, BHB (but not acetoacetate, butyrate, or acetate) selectively inhibited NLRP3 inflammasome activation by blocking K+ efflux and ASC speck formation, independently of TCA cycle oxidation, AMPK, ROS, autophagy, SIRT2, or GPR109A signaling. BHB reduced IL-1β and IL-18 release from human monocytes, and BHB or a ketogenic diet reduced caspase-1 activation and IL-1β production in mouse models of NLRP3-mediated autoinflammatory disease and peritonitis.

Why it matters

This work provides a molecular mechanism linking metabolic states such as fasting, caloric restriction, or ketogenic diets directly to the suppression of innate immune NLRP3 inflammasome activation.

Limits

The abstract does not provide sample sizes, effect sizes, or dose-response metrics. The findings are restricted to cell cultures and rodent disease models, so clinical efficacy and therapeutic dosing in humans remain unestablished.

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