Metabolic Origins of Neurotoxic 1-deoxySphingolipids in Type 2 Diabetes

Type 2 diabetes (T2D) and diabetic peripheral neuropathy (DPN) are associated with disruptions in sphingolipid (SL) metabolism, including an increased formation of neurotoxic 1-deoxysphingolipids (1-deoxySL). Here we report data from an untargeted proteomics, lipidomics and metabolomics profiling in plasma and skin samples of a carefully characterized T2D cohort and age-matched healthy controls. We investigated the association between plasma and skin amino acids and the sphingolipidome in blood and skin of T2D patients and several diabetic rodent models. We developed a hypothesis on how changes in the metabolism of the two amino acids relates to SL formation and DPN. To test this hypothesis and identify key enzymes responsible for the 1-deoxySL formation we developed stable isotope based SL flux assays, using UC13Glucose, 15NGlutamine, D4-Palmitic acid, D4-Alanine and D3N15-Serine as tracers. In combination with genetic interference approaches, we identified pathways that are responsible for shifting between the formation of 1-deoxySL and canonical SL in T2D. Furthermore, we verified these findings in vivo in several rodent models. This study links disturbances in amino acids, lipids, and protein homeostasis to DPN in T2D.