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Diacylglycerol O-acyltransferase 1 (DGAT1) and Diacylglycerol O-acyltransferase 2 (DGAT2) (DGAT1, DGAT2)

Target
DGAT1, DGAT2
Molecular classification
Enzyme, Transferase
01

Overview

Diacylglycerol O-acyltransferases—DGAT1 and DGAT2—are key enzymes responsible for the final step in triglyceride synthesis in the liver. They catalyze the esterification of diacylglycerol with a fatty acyl-CoA to form triacylglycerols. This process occurs primarily at the endoplasmic reticulum membrane. The synthesized triglycerides are then packaged into very-low-density lipoproteins (VLDL) for secretion into circulation or stored within hepatocytes as lipid droplets. Both enzymes play critical roles in energy storage, metabolic regulation during fasting/feeding cycles, and have been implicated in diseases such as non-alcoholic fatty liver disease, obesity-related disorders, cardiovascular disease risk via dyslipidemia, and even viral pathogenesis such as hepatitis C virus replication organelle formation. Inhibition of these enzymes is being explored therapeutically but presents challenges related to systemic lipid handling and potential adverse effects on hepatic function.

Other names
Acyl-CoA:diacylglycerol acyltransferase 1Acyl-CoA:diacylglycerol acyltransferase 2Triglyceride synthaseTriacylglycerol synthase
02

Mechanism of action

Drugs targeting these enzymes typically act as enzyme inhibitors, blocking the final step of triglyceride synthesis by inhibiting the transfer of an acyl group from acyl-CoA to diacylglycerol, thereby reducing triglyceride production and secretion.

03

Biological functions

Triglyceride synthesis (triacylglycerol biosynthesis)Lipid storage regulationEnergy homeostasis in liver and adipose tissueLipoprotein assembly (VLDL formation)
04

Disease associations

Cardiovascular disease (via dyslipidemia)Non-alcoholic fatty liver disease/steatohepatitisObesity/metabolic syndromeViral infection cofactor (e.g., hepatitis C virus replication organelle formation)
05

Safety considerations

Potential safety concerns with inhibition include gastrointestinal side effects due to impaired fat absorption, possible hepatic lipid accumulation or altered lipid metabolism leading to steatosis or other metabolic disturbances.
06

Interacting drugs

Pradigastat (experimental DGAT1 inhibitor)
07

Biomarkers

No established clinical biomarkers specific for patient selection or efficacy monitoring of DGAT inhibition; hepatic triglyceride content and plasma VLDL/triglycerides may serve as indirect markers.

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