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Gastroenterology 2020-Jul

FXR Isoforms Control Different Metabolic Functions in Liver Cells via Binding to Specific DNA Motifs

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Jose Pittol
Alexandra Milona
Imogen Morris
Ellen Willemsen
Suzanne van der Veen
Eric Kalkhoven
Saskia van Mil

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Background & aims: The nuclear receptor subfamily 1 group H member 4 (NR1H4, also called FXR) is a ligand-activated transcription factor that, upon binding of bile acids, regulates expression of genes involved in bile acid, fat, sugar, and amino acid metabolism. Transcript variants encode the FXR isoforms alpha1, alpha2, alpha3, and alpha4, which activate different genes that regulate metabolism. Little is known about the mechanisms by which the different isoforms regulate specific genes or how expression of these genes affects outcomes of patients given drugs that target FXR.

Methods: We determined genome-wide binding of FXR isoforms in mouse liver organoids that express individual FXR isoforms using chromatin immunoprecipitation, followed by sequencing analysis and DNA motif discovery. We validated regulatory DNA sequences by mobility shift assays and with luciferase reporters using mouse and human FXR isoforms. We analyzed mouse liver organoids and HepG2 cells that expressed the FXR isoforms using chromatin immunoprecipitation, quantitative PCR, and immunoblot assays. Organoids were analyzed for mitochondrial respiration, lipid droplet content, and triglyceride excretion. We used the FXR ligand obeticholic acid to induce FXR activity in organoids, cell lines and mice. We collected data on binding of FXR in mouse liver, and expression levels of FXR isoforms and gene targets in human liver tissue and primary human hepatocytes, from the Gene Expression Omnibus.

Results: In mouse liver cells, 89% of sites that bound FXR were bound by only FXRα2 or FXRα4, via direct interactions with the DNA sequence motif ER-2. Via binding, these isoforms regulated metabolic functions in liver cells, including carbon metabolism and lipogenesis. Incubation with obeticholic acid increased mitochondrial pyruvate transport and reduced insulin-induced lipogenesis in organoids that expressed FXRα2 but not FXRα1. In human liver tissues, levels of FXRα2 varied significantly and correlated with expression of genes predicted to be regulated via an ER-2 motif.

Conclusion: Most metabolic effects regulated by FXR in mouse and human liver cells are regulated by the FXRα2 isoform via specific binding to ER-2 motifs. Expression level of FXRα2 in liver might be used to predict responses of patients to treatment with FXR agonists.

Keywords: NASH; OCA; fatty liver; steatosis.

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