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Cell Metab. 2021 Dec 07;33(12):2316-2328. doi: 10.1016/j.cmet.2021.09.004. Epub 2021 Oct 06.

"Sweet death": Fructose as a metabolic toxin that targets the gut-liver axis.

Cell metabolism

Mark A Febbraio, Michael Karin

Affiliations

  1. Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, VIC, Australia. Electronic address: [email protected].
  2. Department of Pharmacology, School of Medicine, University of California, San Diego, San Diego, CA, USA. Electronic address: [email protected].

PMID: 34619076 PMCID: PMC8665123 DOI: 10.1016/j.cmet.2021.09.004

Abstract

Glucose and fructose are closely related simple sugars, but fructose has been associated more closely with metabolic disease. Until the 1960s, the major dietary source of fructose was fruit, but subsequently, high-fructose corn syrup (HFCS) became a dominant component of the Western diet. The exponential increase in HFCS consumption correlates with the increased incidence of obesity and type 2 diabetes mellitus, but the mechanistic link between these metabolic diseases and fructose remains tenuous. Although dietary fructose was thought to be metabolized exclusively in the liver, evidence has emerged that it is also metabolized in the small intestine and leads to intestinal epithelial barrier deterioration. Along with the clinical manifestations of hereditary fructose intolerance, these findings suggest that, along with the direct effect of fructose on liver metabolism, the gut-liver axis plays a key role in fructose metabolism and pathology. Here, we summarize recent studies on fructose biology and pathology and discuss new opportunities for prevention and treatment of diseases associated with high-fructose consumption.

Published by Elsevier Inc.

Keywords: NASH; cancer; fructos; gut inflammation; metabolic disease

Conflict of interest statement

Declaration of interests M.K. holds US Patent No. 10034462 B2 on the use of MUP-uPA mice for the study of NASH and NASH-driven HCC. M.A.F. is a co-inventor of IC7Fc and hold patents for this molecule

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