HMGCS2 and Sepsis: Gene expression of ketolytic enzymes SCOT (Oxct1; Fig. 4.4) and ACAT (Acat1; Fig. 4.5) was downregulated in acute and prolonged sepsis, whereas expression of ketogenic enzyme HMGCS2 (hmgcs2) was upregulated in acute, but not in prolonged sepsis (Fig. 4.6).