Articles

Ketogenic diet regulates Uch-L1(C) to improve cerebral energy metabolism and cognitive function in Alzheimer's disease mice

Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Published: 20 April 2026
207
Views
204
Downloads
6
HTML

Authors

The ketogenic diet (KD), a high-fat, low-carbohydrate diet, can effectively regulate energy metabolism in the brain. The regulation of cerebral energy metabolism in patients with Alzheimer's disease (AD) has attracted the attention of researchers. Recent studies have shown that ubiquitin carboxyl terminal hydrolase L1 (Uch-L1) deficiency leads to neurodegeneration by increasing energy demand and endoplasmic reticulum stress. However, the effect of Uch-L1 on AD remains to be explored. This study first combined Uch-L1 with cerebral energy metabolism to explore its role in long-term KD in AD. We found that AD mice with long-term KD showed better spatial recognition and working memory. KD promoted Uch-L1(C) and Mfn2 expression by inhibiting oxidative stress in the hippocampus of mice, improved mitochondrial function, increased ATP content, and significantly reduced neuronal apoptosis. In conclusion, KD can increase Uch-L1(C) and Mfn2 expression in the brain, and improve cerebral energy metabolism and cognitive function in AD mice.

Downloads

Download data is not yet available.

Citations

1. Joe E, Ringman JM. Cognitive symptoms of Alzheimer's disease: clinical management and prevention. BMJ 2019;367:l6217. DOI: https://doi.org/10.1136/bmj.l6217
2. Herholz K, Haense C, Gerhard A, Jones M, Anton-Rodriguez J, Segobin S, et al. Metabolic regional and network changes in Alzheimer's disease subtypes. J Cereb Blood Flow Metabol 2018;38:1796-806. DOI: https://doi.org/10.1177/0271678X17718436
3. Cunnane SC, Trushina E, Morland C, Prigione A, Casadesus G, Andrews ZB, et al. Brain energy rescue: an emerging therapeutic concept for neurodegenerative disorders of ageing. Nat Rev Drug Discov 2020;19:609-33. DOI: https://doi.org/10.1038/s41573-020-0072-x
4. Kingwell K. Turning up mitophagy in Alzheimer disease. Nat Rev Drug Discov 2019:10-1038. DOI: https://doi.org/10.1038/d41573-019-00035-6
5. Li W, Kui L, Demetrios T, Gong X, Tang M. A Glimmer of hope: maintain mitochondrial homeostasis to mitigate Alzheimer's disease. Aging Dis 2020;11:1260-75. DOI: https://doi.org/10.14336/AD.2020.0105
6. Broom GM, Shaw IC, Rucklidge JJ. The ketogenic diet as a potential treatment and prevention strategy for Alzheimer's disease. Nutrition 2019;60:118-21. DOI: https://doi.org/10.1016/j.nut.2018.10.003
7. Pavón S, Lázaro E, Martínez O, Amayra I, López-Paz JF, Caballero P, et al. Ketogenic diet and cognition in neurological diseases: a systematic review. Nutr Rev 2021;79:802-13. DOI: https://doi.org/10.1093/nutrit/nuaa113
8. Poff AM, Moss S, Soliven M, D'Agostino DP. Ketone supplementation: meeting the needs of the brain in an energy crisis. Front Nutr 2021;8:783659. DOI: https://doi.org/10.3389/fnut.2021.783659
9. Włodarek D. Role of ketogenic diets in neurodegenerative diseases (Alzheimer's disease and Parkinson's disease). Nutrients 2019;11:169. DOI: https://doi.org/10.3390/nu11010169
10. Jensen NJ, Wodschow HZ, Nilsson M, Rungby J. Effects of ketone bodies on brain metabolism and function in neurodegenerative diseases. Int J Mol Sci 2020;21:8767. DOI: https://doi.org/10.3390/ijms21228767
11. Vinciguerra F, Graziano M, Hagnäs M, Frittitta L, Tumminia A. Influence of the Mediterranean and ketogenic diets on cognitive status and decline: a narrative review. Nutrients 2020;12:1019. DOI: https://doi.org/10.3390/nu12041019
12. Rusek M, Pluta R, Ułamek-Kozioł M, Czuczwar SJ. Ketogenic diet in Alzheimer's disease. Int J Mol Sci 2019;20:3892. DOI: https://doi.org/10.3390/ijms20163892
13. Mujica-Parodi LR, Amgalan A, Sultan SF, Antal B, Sun X, Skiena S, et al. Diet modulates brain network stability, a biomarker for brain aging, in young adults. P Natl Acad Sci USA 2020;117:6170-7. DOI: https://doi.org/10.1073/pnas.1913042117
14. Bishop P, Rocca D, Henley JM. Ubiquitin C-terminal hydrolase L1 (UCH-L1): structure, distribution and roles in brain function and dysfunction. The Biochemical Journal 2016;473:2453-62. DOI: https://doi.org/10.1042/BCJ20160082
15. Wang KK, Yang Z, Sarkis G, Torres I, Raghavan V. Ubiquitin C-terminal hydrolase-L1 (UCH-L1) as a therapeutic and diagnostic target in neurodegeneration, neurotrauma and neuro-injuries. Expert Opin Ther Tar 2017;21:627-38. DOI: https://doi.org/10.1080/14728222.2017.1321635
16. Gong B, Cao Z, Zheng P, Vitolo OV, Liu S, Staniszewski A, et al. Ubiquitin hydrolase Uch-L1 rescues beta-amyloid-induced decreases in synaptic function and contextual memory. Cell 2006;126:775-88. DOI: https://doi.org/10.1016/j.cell.2006.06.046
17. Chen J, Huang RY, Turko IV. Mass spectrometry assessment of ubiquitin carboxyl-terminal hydrolase L1 partitioning between soluble and particulate brain homogenate fractions. Anal Chem 2013;85:6011-7. DOI: https://doi.org/10.1021/ac400831z
18. Reinicke AT, Laban K, Sachs M, Kraus V, Walden M, Damme M, et al. Ubiquitin C-terminal hydrolase L1 (UCH-L1) loss causes neurodegeneration by altering protein turnover in the first postnatal weeks. P Natl Acad Sci USA 2019;116:7963-72. DOI: https://doi.org/10.1073/pnas.1812413116
19. Butterfield DA. Ubiquitin carboxyl-terminal hydrolase L-1 in brain: Focus on its oxidative/nitrosative modification and role in brains of subjects with Alzheimer disease and mild cognitive impairment. Free Radical Bio Med 2021;177:278-86. DOI: https://doi.org/10.1016/j.freeradbiomed.2021.10.036
20. Puri S, Hsu SD. Cross-over loop cysteine C152 acts as an antioxidant to maintain the folding stability and deubiquitinase activity of UCH-L1 under oxidative Stress. J Mol Biol 2021;433:166879. DOI: https://doi.org/10.1016/j.jmb.2021.166879
21. Nakamura T, Oh C, Liao L, Zhang X, Lopez KM, Gibbs D, et al. Noncanonical transnitrosylation network contributes to synapse loss in Alzheimer's disease. Science 2021;371:eaaw0843. DOI: https://doi.org/10.1126/science.aaw0843
22. Bishop P, Rubin P, Thomson AR, Rocca D, Henley JM. The ubiquitin C-terminal hydrolase L1 (UCH-L1) C terminus plays a key role in protein stability, but its farnesylation is not required for membrane association in primary neurons. J Biol Chemi2014;289:36140-9. DOI: https://doi.org/10.1074/jbc.M114.557124
23. Liu Z, Meray RK, Grammatopoulos TN, Fredenburg RA, Cookson MR, Liu Y, et al. Membrane-associated farnesylated UCH-L1 promotes alpha-synuclein neurotoxicity and is a therapeutic target for Parkinson's disease. P Natl Acad Sci USA 2009;106:4635-40. DOI: https://doi.org/10.1073/pnas.0806474106
24. Gegg ME, Cooper JM, Chau K, Rojo M, Schapira AHV, Taanman J. Mitofusin 1 and mitofusin 2 are ubiquitinated in a PINK1/parkin-dependent manner upon induction of mitophagy. Hum Mol Genet 2010;19:4861-70. DOI: https://doi.org/10.1093/hmg/ddq419
25. Cerqueira FM, von Stockum S, Giacomello M, Goliand I, Kakimoto P, Marchesan E, et al. A new target for an old DUB: UCH-L1 regulates mitofusin-2 levels, altering mitochondrial morphology, function and calcium uptake. Redox Biol 2020;37:101676. DOI: https://doi.org/10.1016/j.redox.2020.101676
26. Suryavanshi PS, Ugale RR, Yilmazer-Hanke D, Stairs DJ, Dravid SM. GluN2C/GluN2D subunit-selective NMDA receptor potentiator CIQ reverses MK-801-induced impairment in prepulse inhibition and working memory in Y-maze test in mice. Brit J Pharmacol 2014;171:799-809. DOI: https://doi.org/10.1111/bph.12518
27. Lauretti E, Nenov M, Dincer O, Iuliano L, Praticò D. Extra virgin olive oil improves synaptic activity, short-term plasticity, memory, and neuropathology in a tauopathy model. Aging Cell 2020;19:e13076. DOI: https://doi.org/10.1111/acel.13076
28. Lam J, Katti P, Biete M, Mungai M, AshShareef S, Neikirk K, et al. A universal approach to analyzing transmission electron microscopy with ImageJ. Cells 2021;10:2177. DOI: https://doi.org/10.3390/cells10092177
29. Cioffi F, Adam RHI, Broersen K. Molecular mechanisms and genetics of oxidative stress in Alzheimer's disease. J Alzheimers Dis 2019;72:981-1017. DOI: https://doi.org/10.3233/JAD-190863
30. Naon D, Zaninello M, Giacomello M, Varanita T, Grespi F, Lakshminaranayan S, et al. Critical reappraisal confirms that Mitofusin 2 is an endoplasmic reticulum-mitochondria tether. P Natl Acad Sci USA 2016;113:11249-54. DOI: https://doi.org/10.1073/pnas.1606786113
31. Csordás G, Renken C, Várnai P, Walter L, Weaver D, Buttle KF, et al. Structural and functional features and significance of the physical linkage between ER and mitochondria. J Cell Biol 2006;174:915-21. DOI: https://doi.org/10.1083/jcb.200604016
32. Wang Q, Kong Y, Wu D, Liu J, Jie W, You Q, et al. Impaired calcium signaling in astrocytes modulates autism spectrum disorder-like behaviors in mice. Nat Commun 2021;12:3321. DOI: https://doi.org/10.1038/s41467-021-23843-0
33. Jia L, Quan M, Fu Y, Zhao T, Li Y, Wei C, et al. Dementia in China: epidemiology, clinical management, and research advances. Lancet Neurol 2020;19:81-92. DOI: https://doi.org/10.1016/S1474-4422(19)30290-X
34. Kim K, Lee CH, Park CB. Chemical sensing platforms for detecting trace-level Alzheimer's core biomarkers. Chem Soc Rev 2020;49:5446-72. DOI: https://doi.org/10.1039/D0CS00107D
35. Brownlow ML, Benner L, D'Agostino D, Gordon MN, Morgan D. Ketogenic diet improves motor performance but not cognition in two mouse models of Alzheimer's pathology. PloS One 2013;8:e75713. DOI: https://doi.org/10.1371/journal.pone.0075713
36. Xu Y, Jiang C, Wu J, Liu P, Deng X, Zhang Y, et al. Ketogenic diet ameliorates cognitive impairment and neuroinflammation in a mouse model of Alzheimer's disease. CNS Neurosci Ther 2022;28:580-92. DOI: https://doi.org/10.1111/cns.13779
37. Qin Y, Bai D, Tang M, Zhang M, Zhao L, Li J, et al. Ketogenic diet alleviates brain iron deposition and cognitive dysfunction via Nrf2-mediated ferroptosis pathway in APP/PS1 mouse. Brain Res 2023;1812:148404. DOI: https://doi.org/10.1016/j.brainres.2023.148404
38. Yin JX, Maalouf M, Han P, Zhao M, Gao M, Dharshaun T, et al. Ketones block amyloid entry and improve cognition in an Alzheimer's model. Neurobiol Aging 2016;39:25-37. DOI: https://doi.org/10.1016/j.neurobiolaging.2015.11.018
39. Chu C, Yu L, Qi G, Mi Y, Wu W, Lee Y, et al. Can dietary patterns prevent cognitive impairment and reduce Alzheimer's disease risk: Exploring the underlying mechanisms of effects. Neurosci Biobehav Rev 2022;135:104556. DOI: https://doi.org/10.1016/j.neubiorev.2022.104556
40. Corrigan JK, Ramachandran D, He Y, Palmer CJ, Jurczak MJ, Chen R, et al. A big-data approach to understanding metabolic rate and response to obesity in laboratory mice. Elife 2020;9:e53560. DOI: https://doi.org/10.7554/eLife.53560
41. Qizilbash N, Gregson J, Johnson ME, Pearce N, Douglas I, Wing K, et al. BMI and risk of dementia in two million people over two decades: a retrospective cohort study. Lancet Diabetes Endocrinol 2015;3:431-6. DOI: https://doi.org/10.1016/S2213-8587(15)00033-9
42. Paoli A, Rubini A, Volek JS, Grimaldi KA. Beyond weight loss: a review of the therapeutic uses of very-low-carbohydrate (ketogenic) diets. Eur J Clin Nutr 2013;67:789-96. DOI: https://doi.org/10.1038/ejcn.2013.116
43. Sullivan PG, Rippy NA, Dorenbos K, Concepcion RC, Agarwal AK, Rho JM. The ketogenic diet increases mitochondrial uncoupling protein levels and activity. Ann Neurol 2004;55:576-80. DOI: https://doi.org/10.1002/ana.20062
44. Croteau E, Castellano CA, Fortier M, Bocti C, Fulop T, Paquet N, et al. A cross-sectional comparison of brain glucose and ketone metabolism in cognitively healthy older adults, mild cognitive impairment and early Alzheimer's disease. Exp Gerontol 2018;107:18-26. DOI: https://doi.org/10.1016/j.exger.2017.07.004
45. Cunnane SC, Courchesne-Loyer A, St-Pierre V, Vandenberghe C, Pierotti T, Fortier M, et al. Can ketones compensate for deteriorating brain glucose uptake during aging? Implications for the risk and treatment of Alzheimer's disease. Ann NY Acad Sci 2016;1367:12-20. DOI: https://doi.org/10.1111/nyas.12999
46. Chen H, Detmer SA, Ewald AJ, Griffin EE, Fraser SE, Chan DC. Mitofusins Mfn1 and Mfn2 coordinately regulate mitochondrial fusion and are essential for embryonic development. J Cell Biol 2003;160:189-200. DOI: https://doi.org/10.1083/jcb.200211046
47. McLelland G, Goiran T, Yi W, Dorval G, Chen CX, Lauinger ND, et al. Mfn2 ubiquitination by PINK1/parkin gates the p97-dependent release of ER from mitochondria to drive mitophagy. Elife 2018;7:e32866. DOI: https://doi.org/10.7554/eLife.32866
48. Che L, Yang C, Chen Y, Wu Z, Du Z, Wu J, et al. Mitochondrial redox-driven mitofusin 2 S-glutathionylation promotes neuronal necroptosis via disrupting ER-mitochondria crosstalk in cadmium-induced neurotoxicity. Chemosphere 2021;262:127878. DOI: https://doi.org/10.1016/j.chemosphere.2020.127878
49. Hailey DW, Rambold AS, Satpute-Krishnan P, Mitra K, Sougrat R, Kim PK, et al. Mitochondria supply membranes for autophagosome biogenesis during starvation. Cell 2010;141:656-67. DOI: https://doi.org/10.1016/j.cell.2010.04.009
50. Hamasaki M, Furuta N, Matsuda A, Nezu A, Yamamoto A, Fujita N, et al. Autophagosomes form at ER-mitochondria contact sites. Nature 2013;495:389-93. DOI: https://doi.org/10.1038/nature11910
51. Degechisa ST, Dabi YT, Gizaw ST. The mitochondrial associated endoplasmic reticulum membranes: A platform for the pathogenesis of inflammation-mediated metabolic diseases. Immun Inflamm Dis 2022;10:e647. DOI: https://doi.org/10.1002/iid3.647
52. de Brito OM, Scorrano L. Mitofusin 2 tethers endoplasmic reticulum to mitochondria. Nature 2008;456:605-10. DOI: https://doi.org/10.1038/nature07534
53. Chandhok G, Lazarou M, Neumann B. Structure, function, and regulation of mitofusin-2 in health and disease. Biol Rev Camb Philos Soc 2018;93:933-49. DOI: https://doi.org/10.1111/brv.12378
54. Akbari M, Kirkwood TBL, Bohr VA. Mitochondria in the signaling pathways that control longevity and health span. Ageing Res Rev 2019;54:100940. DOI: https://doi.org/10.1016/j.arr.2019.100940
55. Chen X, Hao B, Li D, Reiter RJ, Bai Y, Abay B, et al. Melatonin inhibits lung cancer development by reversing the Warburg effect via stimulating the SIRT3/PDH axis. J Pineal Res 2021;71:e12755. DOI: https://doi.org/10.1111/jpi.12755
56. Zhang M, Chen M, Wang S, Ding X, Yang R, Li J, et al. Association of ubiquitin C-terminal hydrolase-L1 (Uch-L1) serum levels with cognition and brain energy metabolism. Eur Rev Med Pharmacol 2022;26:3656-63.
57. Bazarian JJ, Biberthaler P, Welch RD, Lewis LM, Barzo P, Bogner-Flatz V, et al. Serum GFAP and UCH-L1 for prediction of absence of intracranial injuries on head CT (ALERT-TBI): a multicentre observational study. Lancet Neurol 2018;17:782-9. DOI: https://doi.org/10.1016/S1474-4422(18)30231-X
58. Lippa SM, Gill J, Brickell TA, French LM, Lange RT. Blood biomarkers relate to cognitive performance years after traumatic brain injury in service members and veterans. J Int Neuropsychol Soc 2021;27:508-14. DOI: https://doi.org/10.1017/S1355617720001071
59. Iqbal K, Grundke-Iqbal I. Alzheimer's disease, a multifactorial disorder seeking multitherapies. Alzheimers Dement 2010;6:420-4. DOI: https://doi.org/10.1016/j.jalz.2010.04.006

Ethics Approval

All animal experimental procedures were reviewed and approved by the Animal Ethics Committee of North Sichuan Medical College

CRediT authorship contribution

Nana Bao, Guohui Jiang, conceptualization, methodology, experiments design, proposed and secured funding for this project. Min Zhang, Ming Tang, Ziyi Shen, performed the research. Shenglin Wang, contributed to the analytic tools. Min Zhang, analyzed the data and wrote the article. Ming Tang, Shenglin Wang, Guohui Jiang, writing - review & editing. All authors contributed to the article and approved the final version.

Supporting Agencies

North Sichuan Medical College , Primary Health Development Research Center of Sichuan Province

Data Availability Statement

The data supporting the conclusions of this article will be made available by contacting the corresponding author.

How to Cite



1.
Bao N, Zhang M, Tang M, Shen Z, Wang S, Jiang G. Ketogenic diet regulates Uch-L1(C) to improve cerebral energy metabolism and cognitive function in Alzheimer’s disease mice. Eur J Histochem [Internet]. 2026 Apr. 20 [cited 2026 May 10];70(2). Available from: https://www.ejh.it/ejh/article/view/4548