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D-β-Hydroxybutyrate rescues mitochondrial respiration and mitigates features of Parkinson disease
Kim Tieu, Celine Perier, Casper Caspersen, Peter Teismann, Du-Chu Wu, Shi-Du Yan, Ali Naini, Miquel Vila, Vernice Jackson-Lewis, Ravichandran Ramasamy, Serge Przedborski
Kim Tieu, Celine Perier, Casper Caspersen, Peter Teismann, Du-Chu Wu, Shi-Du Yan, Ali Naini, Miquel Vila, Vernice Jackson-Lewis, Ravichandran Ramasamy, Serge Przedborski
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Article Neuroscience

D-β-Hydroxybutyrate rescues mitochondrial respiration and mitigates features of Parkinson disease

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Abstract

Parkinson disease (PD) is a neurodegenerative disorder characterized by a loss of the nigrostriatal dopaminergic neurons accompanied by a deficit in mitochondrial respiration. 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) is a neurotoxin that causes dopaminergic neurodegeneration and a mitochondrial deficit reminiscent of PD. Here we show that the infusion of the ketone body D-β-hydroxybutyrate (DβHB) in mice confers partial protection against dopaminergic neurodegeneration and motor deficits induced by MPTP. These effects appear to be mediated by a complex II–dependent mechanism that leads to improved mitochondrial respiration and ATP production. Because of the safety record of ketone bodies in the treatment of epilepsy and their ability to penetrate the blood-brain barrier, DβHB may be a novel neuroprotective therapy for PD.

Authors

Kim Tieu, Celine Perier, Casper Caspersen, Peter Teismann, Du-Chu Wu, Shi-Du Yan, Ali Naini, Miquel Vila, Vernice Jackson-Lewis, Ravichandran Ramasamy, Serge Przedborski

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Figure 1

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Brain levels of DβHB and β-hydroxybutyrate dehydrogenase (βHBD) under di...
Brain levels of DβHB and β-hydroxybutyrate dehydrogenase (βHBD) under different treatments. (a) One day after implantation of pumps containing DβHB, animals were injected intraperitoneally with saline (Sal), MPTP, or 3-NP as described in Methods, and brain levels of DβHB were measured at 0 days (90 minutes after the fourth injection), 2 days, and 7 days thereafter. The utilization of DβHB was increased when cells were under metabolic stress induced by these toxins. n = 4–6; *P < 0.05 and **P < 0.01 compared with the respective control saline groups. (b) Western blot analysis of ventral midbrains from MPTP-intoxicated mice shows upregulation of this enzyme as early as day 0. n = 4–5 per group; *P < 0.05 compared with the control saline group. β-Actin is used to normalize βHBD values.

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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