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ResearchIn-Press PreviewImmunologyMetabolism Open Access | 10.1172/JCI182480

Acetyl-CoA carboxylase-1 inhibition increases regulatory T-Cell metabolism and graft-vs-host disease treatment efficacy via mitochondrial fusion

Cameron McDonald-Hyman,1 Ethan G. Aguilar,2 Ewoud B. Compeer,3 Michael C. Zaiken,2 Stephanie Y. Rhee,2 Fathima A. Mohamed,2 Jemma H. Larson,2 Michael L. Loschi,2 Christopher Lees,2 Govindarajan Thangavelu,2 Margaret L. Sleeth,2 Kyle D. Smith,2 Jennifer S. Whangbo,4 Jerome Ritz,5 Tim D. Sparwasser,6 Roddy S. O'Connor,7 Peter A. Crawford,8 Jeffrey C. Rathmell,9 Leslie S. Kean,4 Robert Zeiser,10 Keli L. Hippen,2 Michael L. Dustin,11 and Bruce R. Blazar2

1Division of Hematology/Oncology/Transplantation, University of Minnesota, Minneapolis, United States of America

2Division of Blood & Marrow Transplant, University of Minnesota, Minneapolis, United States of America

3Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom

4Division of Hematology/Oncology, Harvard Medical School, Boston, United States of America

5Division of Hematologic Malignancies, Harvard Medical School, Boston, United States of America

6Institute of Medical Microbiology and Hygiene, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany

7Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States of America

8Division of Molecular Medicine, University of Minnesota, Minneapolis, United States of America

9Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, United States of America

10Department of Medicine I, University Medical Centre Freiburg, Freiburg, Germany

11Kennedy Institute of Rheumatology, The University of Oxford, Oxford, United Kingdom

Find articles by McDonald-Hyman, C. in: PubMed | Google Scholar |

1Division of Hematology/Oncology/Transplantation, University of Minnesota, Minneapolis, United States of America

2Division of Blood & Marrow Transplant, University of Minnesota, Minneapolis, United States of America

3Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom

4Division of Hematology/Oncology, Harvard Medical School, Boston, United States of America

5Division of Hematologic Malignancies, Harvard Medical School, Boston, United States of America

6Institute of Medical Microbiology and Hygiene, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany

7Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States of America

8Division of Molecular Medicine, University of Minnesota, Minneapolis, United States of America

9Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, United States of America

10Department of Medicine I, University Medical Centre Freiburg, Freiburg, Germany

11Kennedy Institute of Rheumatology, The University of Oxford, Oxford, United Kingdom

Find articles by Aguilar, E. in: PubMed | Google Scholar |

1Division of Hematology/Oncology/Transplantation, University of Minnesota, Minneapolis, United States of America

2Division of Blood & Marrow Transplant, University of Minnesota, Minneapolis, United States of America

3Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom

4Division of Hematology/Oncology, Harvard Medical School, Boston, United States of America

5Division of Hematologic Malignancies, Harvard Medical School, Boston, United States of America

6Institute of Medical Microbiology and Hygiene, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany

7Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States of America

8Division of Molecular Medicine, University of Minnesota, Minneapolis, United States of America

9Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, United States of America

10Department of Medicine I, University Medical Centre Freiburg, Freiburg, Germany

11Kennedy Institute of Rheumatology, The University of Oxford, Oxford, United Kingdom

Find articles by Compeer, E. in: PubMed | Google Scholar

1Division of Hematology/Oncology/Transplantation, University of Minnesota, Minneapolis, United States of America

2Division of Blood & Marrow Transplant, University of Minnesota, Minneapolis, United States of America

3Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom

4Division of Hematology/Oncology, Harvard Medical School, Boston, United States of America

5Division of Hematologic Malignancies, Harvard Medical School, Boston, United States of America

6Institute of Medical Microbiology and Hygiene, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany

7Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States of America

8Division of Molecular Medicine, University of Minnesota, Minneapolis, United States of America

9Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, United States of America

10Department of Medicine I, University Medical Centre Freiburg, Freiburg, Germany

11Kennedy Institute of Rheumatology, The University of Oxford, Oxford, United Kingdom

Find articles by Zaiken, M. in: PubMed | Google Scholar

1Division of Hematology/Oncology/Transplantation, University of Minnesota, Minneapolis, United States of America

2Division of Blood & Marrow Transplant, University of Minnesota, Minneapolis, United States of America

3Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom

4Division of Hematology/Oncology, Harvard Medical School, Boston, United States of America

5Division of Hematologic Malignancies, Harvard Medical School, Boston, United States of America

6Institute of Medical Microbiology and Hygiene, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany

7Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States of America

8Division of Molecular Medicine, University of Minnesota, Minneapolis, United States of America

9Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, United States of America

10Department of Medicine I, University Medical Centre Freiburg, Freiburg, Germany

11Kennedy Institute of Rheumatology, The University of Oxford, Oxford, United Kingdom

Find articles by Rhee, S. in: PubMed | Google Scholar

1Division of Hematology/Oncology/Transplantation, University of Minnesota, Minneapolis, United States of America

2Division of Blood & Marrow Transplant, University of Minnesota, Minneapolis, United States of America

3Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom

4Division of Hematology/Oncology, Harvard Medical School, Boston, United States of America

5Division of Hematologic Malignancies, Harvard Medical School, Boston, United States of America

6Institute of Medical Microbiology and Hygiene, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany

7Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States of America

8Division of Molecular Medicine, University of Minnesota, Minneapolis, United States of America

9Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, United States of America

10Department of Medicine I, University Medical Centre Freiburg, Freiburg, Germany

11Kennedy Institute of Rheumatology, The University of Oxford, Oxford, United Kingdom

Find articles by Mohamed, F. in: PubMed | Google Scholar

1Division of Hematology/Oncology/Transplantation, University of Minnesota, Minneapolis, United States of America

2Division of Blood & Marrow Transplant, University of Minnesota, Minneapolis, United States of America

3Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom

4Division of Hematology/Oncology, Harvard Medical School, Boston, United States of America

5Division of Hematologic Malignancies, Harvard Medical School, Boston, United States of America

6Institute of Medical Microbiology and Hygiene, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany

7Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States of America

8Division of Molecular Medicine, University of Minnesota, Minneapolis, United States of America

9Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, United States of America

10Department of Medicine I, University Medical Centre Freiburg, Freiburg, Germany

11Kennedy Institute of Rheumatology, The University of Oxford, Oxford, United Kingdom

Find articles by Larson, J. in: PubMed | Google Scholar

1Division of Hematology/Oncology/Transplantation, University of Minnesota, Minneapolis, United States of America

2Division of Blood & Marrow Transplant, University of Minnesota, Minneapolis, United States of America

3Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom

4Division of Hematology/Oncology, Harvard Medical School, Boston, United States of America

5Division of Hematologic Malignancies, Harvard Medical School, Boston, United States of America

6Institute of Medical Microbiology and Hygiene, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany

7Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States of America

8Division of Molecular Medicine, University of Minnesota, Minneapolis, United States of America

9Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, United States of America

10Department of Medicine I, University Medical Centre Freiburg, Freiburg, Germany

11Kennedy Institute of Rheumatology, The University of Oxford, Oxford, United Kingdom

Find articles by Loschi, M. in: PubMed | Google Scholar

1Division of Hematology/Oncology/Transplantation, University of Minnesota, Minneapolis, United States of America

2Division of Blood & Marrow Transplant, University of Minnesota, Minneapolis, United States of America

3Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom

4Division of Hematology/Oncology, Harvard Medical School, Boston, United States of America

5Division of Hematologic Malignancies, Harvard Medical School, Boston, United States of America

6Institute of Medical Microbiology and Hygiene, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany

7Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States of America

8Division of Molecular Medicine, University of Minnesota, Minneapolis, United States of America

9Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, United States of America

10Department of Medicine I, University Medical Centre Freiburg, Freiburg, Germany

11Kennedy Institute of Rheumatology, The University of Oxford, Oxford, United Kingdom

Find articles by Lees, C. in: PubMed | Google Scholar

1Division of Hematology/Oncology/Transplantation, University of Minnesota, Minneapolis, United States of America

2Division of Blood & Marrow Transplant, University of Minnesota, Minneapolis, United States of America

3Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom

4Division of Hematology/Oncology, Harvard Medical School, Boston, United States of America

5Division of Hematologic Malignancies, Harvard Medical School, Boston, United States of America

6Institute of Medical Microbiology and Hygiene, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany

7Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States of America

8Division of Molecular Medicine, University of Minnesota, Minneapolis, United States of America

9Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, United States of America

10Department of Medicine I, University Medical Centre Freiburg, Freiburg, Germany

11Kennedy Institute of Rheumatology, The University of Oxford, Oxford, United Kingdom

Find articles by Thangavelu, G. in: PubMed | Google Scholar

1Division of Hematology/Oncology/Transplantation, University of Minnesota, Minneapolis, United States of America

2Division of Blood & Marrow Transplant, University of Minnesota, Minneapolis, United States of America

3Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom

4Division of Hematology/Oncology, Harvard Medical School, Boston, United States of America

5Division of Hematologic Malignancies, Harvard Medical School, Boston, United States of America

6Institute of Medical Microbiology and Hygiene, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany

7Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States of America

8Division of Molecular Medicine, University of Minnesota, Minneapolis, United States of America

9Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, United States of America

10Department of Medicine I, University Medical Centre Freiburg, Freiburg, Germany

11Kennedy Institute of Rheumatology, The University of Oxford, Oxford, United Kingdom

Find articles by Sleeth, M. in: PubMed | Google Scholar

1Division of Hematology/Oncology/Transplantation, University of Minnesota, Minneapolis, United States of America

2Division of Blood & Marrow Transplant, University of Minnesota, Minneapolis, United States of America

3Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom

4Division of Hematology/Oncology, Harvard Medical School, Boston, United States of America

5Division of Hematologic Malignancies, Harvard Medical School, Boston, United States of America

6Institute of Medical Microbiology and Hygiene, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany

7Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States of America

8Division of Molecular Medicine, University of Minnesota, Minneapolis, United States of America

9Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, United States of America

10Department of Medicine I, University Medical Centre Freiburg, Freiburg, Germany

11Kennedy Institute of Rheumatology, The University of Oxford, Oxford, United Kingdom

Find articles by Smith, K. in: PubMed | Google Scholar

1Division of Hematology/Oncology/Transplantation, University of Minnesota, Minneapolis, United States of America

2Division of Blood & Marrow Transplant, University of Minnesota, Minneapolis, United States of America

3Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom

4Division of Hematology/Oncology, Harvard Medical School, Boston, United States of America

5Division of Hematologic Malignancies, Harvard Medical School, Boston, United States of America

6Institute of Medical Microbiology and Hygiene, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany

7Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States of America

8Division of Molecular Medicine, University of Minnesota, Minneapolis, United States of America

9Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, United States of America

10Department of Medicine I, University Medical Centre Freiburg, Freiburg, Germany

11Kennedy Institute of Rheumatology, The University of Oxford, Oxford, United Kingdom

Find articles by Whangbo, J. in: PubMed | Google Scholar

1Division of Hematology/Oncology/Transplantation, University of Minnesota, Minneapolis, United States of America

2Division of Blood & Marrow Transplant, University of Minnesota, Minneapolis, United States of America

3Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom

4Division of Hematology/Oncology, Harvard Medical School, Boston, United States of America

5Division of Hematologic Malignancies, Harvard Medical School, Boston, United States of America

6Institute of Medical Microbiology and Hygiene, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany

7Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States of America

8Division of Molecular Medicine, University of Minnesota, Minneapolis, United States of America

9Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, United States of America

10Department of Medicine I, University Medical Centre Freiburg, Freiburg, Germany

11Kennedy Institute of Rheumatology, The University of Oxford, Oxford, United Kingdom

Find articles by Ritz, J. in: PubMed | Google Scholar |

1Division of Hematology/Oncology/Transplantation, University of Minnesota, Minneapolis, United States of America

2Division of Blood & Marrow Transplant, University of Minnesota, Minneapolis, United States of America

3Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom

4Division of Hematology/Oncology, Harvard Medical School, Boston, United States of America

5Division of Hematologic Malignancies, Harvard Medical School, Boston, United States of America

6Institute of Medical Microbiology and Hygiene, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany

7Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States of America

8Division of Molecular Medicine, University of Minnesota, Minneapolis, United States of America

9Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, United States of America

10Department of Medicine I, University Medical Centre Freiburg, Freiburg, Germany

11Kennedy Institute of Rheumatology, The University of Oxford, Oxford, United Kingdom

Find articles by Sparwasser, T. in: PubMed | Google Scholar

1Division of Hematology/Oncology/Transplantation, University of Minnesota, Minneapolis, United States of America

2Division of Blood & Marrow Transplant, University of Minnesota, Minneapolis, United States of America

3Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom

4Division of Hematology/Oncology, Harvard Medical School, Boston, United States of America

5Division of Hematologic Malignancies, Harvard Medical School, Boston, United States of America

6Institute of Medical Microbiology and Hygiene, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany

7Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States of America

8Division of Molecular Medicine, University of Minnesota, Minneapolis, United States of America

9Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, United States of America

10Department of Medicine I, University Medical Centre Freiburg, Freiburg, Germany

11Kennedy Institute of Rheumatology, The University of Oxford, Oxford, United Kingdom

Find articles by O'Connor, R. in: PubMed | Google Scholar

1Division of Hematology/Oncology/Transplantation, University of Minnesota, Minneapolis, United States of America

2Division of Blood & Marrow Transplant, University of Minnesota, Minneapolis, United States of America

3Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom

4Division of Hematology/Oncology, Harvard Medical School, Boston, United States of America

5Division of Hematologic Malignancies, Harvard Medical School, Boston, United States of America

6Institute of Medical Microbiology and Hygiene, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany

7Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States of America

8Division of Molecular Medicine, University of Minnesota, Minneapolis, United States of America

9Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, United States of America

10Department of Medicine I, University Medical Centre Freiburg, Freiburg, Germany

11Kennedy Institute of Rheumatology, The University of Oxford, Oxford, United Kingdom

Find articles by Crawford, P. in: PubMed | Google Scholar |

1Division of Hematology/Oncology/Transplantation, University of Minnesota, Minneapolis, United States of America

2Division of Blood & Marrow Transplant, University of Minnesota, Minneapolis, United States of America

3Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom

4Division of Hematology/Oncology, Harvard Medical School, Boston, United States of America

5Division of Hematologic Malignancies, Harvard Medical School, Boston, United States of America

6Institute of Medical Microbiology and Hygiene, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany

7Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States of America

8Division of Molecular Medicine, University of Minnesota, Minneapolis, United States of America

9Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, United States of America

10Department of Medicine I, University Medical Centre Freiburg, Freiburg, Germany

11Kennedy Institute of Rheumatology, The University of Oxford, Oxford, United Kingdom

Find articles by Rathmell, J. in: PubMed | Google Scholar |

1Division of Hematology/Oncology/Transplantation, University of Minnesota, Minneapolis, United States of America

2Division of Blood & Marrow Transplant, University of Minnesota, Minneapolis, United States of America

3Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom

4Division of Hematology/Oncology, Harvard Medical School, Boston, United States of America

5Division of Hematologic Malignancies, Harvard Medical School, Boston, United States of America

6Institute of Medical Microbiology and Hygiene, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany

7Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States of America

8Division of Molecular Medicine, University of Minnesota, Minneapolis, United States of America

9Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, United States of America

10Department of Medicine I, University Medical Centre Freiburg, Freiburg, Germany

11Kennedy Institute of Rheumatology, The University of Oxford, Oxford, United Kingdom

Find articles by Kean, L. in: PubMed | Google Scholar

1Division of Hematology/Oncology/Transplantation, University of Minnesota, Minneapolis, United States of America

2Division of Blood & Marrow Transplant, University of Minnesota, Minneapolis, United States of America

3Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom

4Division of Hematology/Oncology, Harvard Medical School, Boston, United States of America

5Division of Hematologic Malignancies, Harvard Medical School, Boston, United States of America

6Institute of Medical Microbiology and Hygiene, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany

7Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States of America

8Division of Molecular Medicine, University of Minnesota, Minneapolis, United States of America

9Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, United States of America

10Department of Medicine I, University Medical Centre Freiburg, Freiburg, Germany

11Kennedy Institute of Rheumatology, The University of Oxford, Oxford, United Kingdom

Find articles by Zeiser, R. in: PubMed | Google Scholar |

1Division of Hematology/Oncology/Transplantation, University of Minnesota, Minneapolis, United States of America

2Division of Blood & Marrow Transplant, University of Minnesota, Minneapolis, United States of America

3Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom

4Division of Hematology/Oncology, Harvard Medical School, Boston, United States of America

5Division of Hematologic Malignancies, Harvard Medical School, Boston, United States of America

6Institute of Medical Microbiology and Hygiene, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany

7Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States of America

8Division of Molecular Medicine, University of Minnesota, Minneapolis, United States of America

9Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, United States of America

10Department of Medicine I, University Medical Centre Freiburg, Freiburg, Germany

11Kennedy Institute of Rheumatology, The University of Oxford, Oxford, United Kingdom

Find articles by Hippen, K. in: PubMed | Google Scholar |

1Division of Hematology/Oncology/Transplantation, University of Minnesota, Minneapolis, United States of America

2Division of Blood & Marrow Transplant, University of Minnesota, Minneapolis, United States of America

3Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom

4Division of Hematology/Oncology, Harvard Medical School, Boston, United States of America

5Division of Hematologic Malignancies, Harvard Medical School, Boston, United States of America

6Institute of Medical Microbiology and Hygiene, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany

7Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States of America

8Division of Molecular Medicine, University of Minnesota, Minneapolis, United States of America

9Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, United States of America

10Department of Medicine I, University Medical Centre Freiburg, Freiburg, Germany

11Kennedy Institute of Rheumatology, The University of Oxford, Oxford, United Kingdom

Find articles by Dustin, M. in: PubMed | Google Scholar |

1Division of Hematology/Oncology/Transplantation, University of Minnesota, Minneapolis, United States of America

2Division of Blood & Marrow Transplant, University of Minnesota, Minneapolis, United States of America

3Kennedy Institute of Rheumatology, University of Oxford, Oxford, United Kingdom

4Division of Hematology/Oncology, Harvard Medical School, Boston, United States of America

5Division of Hematologic Malignancies, Harvard Medical School, Boston, United States of America

6Institute of Medical Microbiology and Hygiene, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany

7Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, United States of America

8Division of Molecular Medicine, University of Minnesota, Minneapolis, United States of America

9Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, United States of America

10Department of Medicine I, University Medical Centre Freiburg, Freiburg, Germany

11Kennedy Institute of Rheumatology, The University of Oxford, Oxford, United Kingdom

Find articles by Blazar, B. in: PubMed | Google Scholar |

Published September 30, 2025 - More info

J Clin Invest. https://doi.org/10.1172/JCI182480.
Copyright © 2025, McDonald-Hyman et al. This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Published September 30, 2025 - Version history
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Abstract

Regulatory T-cells (Treg) are critical for maintaining immune homeostasis, and their adoptive transfer can treat murine inflammatory disorders. In patients, Treg therapies have been variably efficacious. Therefore, new strategies to enhance Treg therapeutic efficacy are needed. Treg predominantly depend upon oxidative phosphorylation (OXPHOS) for energy and suppressive function. Fatty acid oxidation (FAO) contributes to Treg OXPHOS and can be important for Treg “effector” differentiation, but FAO activity is inhibited by coordinated activity of isoenzymes acetyl-CoA Carboxylase-1 and -2 (ACC1/2). Here, we show that small molecule inhibition or Treg-specific genetic deletion of ACC1 significantly increases Treg suppressive function in vitro and in mice with established chronic GVHD. ACC1 inhibition skewed Treg towards an “effector” phenotype and enhanced FAO-mediated OXPHOS, mitochondrial function, and mitochondrial fusion. Inhibiting mitochondrial fusion diminished the effect of ACC1 inhibition. Reciprocally, promoting mitochondrial fusion, even in the absence of ACC1 modulation, resulted in a Treg functional and metabolic phenotype similar to ACC1 inhibition, indicating a key role for mitochondrial fusion in Treg suppressive potency. Ex vivo expanded, ACC1 inhibitor treated human Treg similarly augmented suppressor function as observed with murine Treg. Together, these data suggest that ACC1 manipulation may be exploited to modulate Treg function in patients.

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