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Pharmaceuticals and environmental contaminants contribute to hypercholesterolemia. Several chemicals known to cause hypercholesterolemia, activate pregnane X receptor (PXR). PXR is a nuclear receptor, classically identified as a sensor of chemical environment and regulator of detoxification processes. Later, PXR activation has been shown to disrupt metabolic functions such as lipid metabolism and recent findings have shown PXR activation to promote hypercholesterolemia through multiple mechanisms. Hypercholesterolemia is a major causative risk factor for atherosclerosis and greatly promotes global health burden. Metabolic disruption by PXR activating chemicals leading to hypercholesterolemia represents a novel toxicity pathway of concern and requires further attention. Therefore, we constructed an adverse outcome pathway (AOP) by collecting the available knowledge considering the molecular mechanisms for PXR-mediated hypercholesterolemia. AOPs are tools of modern toxicology for systematizing mechanistic knowledge to assist health risk assessment of chemicals. AOPs are formalized and structured linear concepts describing a link between molecular initiating event (MIE) and adverse outcome (AO). MIE and AO are connected via key events (KE) through key event relationships (KER). We present a plausible route of how PXR activation (MIE) leads to hypercholesterolemia (AO) through direct regulation of cholesterol synthesis and via activation of sterol regulatory element binding protein 2-pathway.

Atherosclerosis is a major global health concern. The central modifiable risk factors and causative agents of the disease are high total and low-density lipoprotein (LDL) cholesterol. To reduce morbidity and mortality, a thorough understanding of the factors that influence an individual’s cholesterol status during the decades when the arteria-narrowing arteriosclerotic plaques are forming is critical. Several drugs are known to increase cholesterol levels; however, the mechanisms are poorly understood. Activation of pregnane X receptor (PXR), the major regulator of drug metabolism and molecular mediator of clinically significant drug–drug interactions, has been shown to induce hypercholesterolemia. As a major sensor of the chemical environment, PXR may in part mediate hypercholesterolemic effects of drug treatment. This review compiles the current knowledge of PXR in cholesterol homeostasis and discusses the role of PXR in drug-induced hypercholesterolemia.

Background and purpose: Many drugs and environmental contaminants induce hypercholesterolemia and promote the risk of atherosclerotic cardiovascular disease. We tested the hypothesis that pregnane X receptor (PXR), a xenobiotic-sensing nuclear receptor, regulates the level of circulating atherogenic lipids in humans and utilized mouse experiments to identify the mechanisms involved. Experimental approach: We performed serum NMR metabolomics in healthy volunteers administered rifampicin, a prototypical human PXR ligand or placebo in a crossover setting. We used high-fat diet fed wild-type and PXR knockout mice to investigate the mechanisms mediating the PXR-induced alterations in cholesterol homeostasis. Key results: Activation of PXR induced cholesterogenesis both in pre-clinical and clinical settings. In human volunteers, rifampicin increased intermediate-density lipoprotein (IDL), low-density lipoprotein (LDL) and total cholesterol and lathosterol–cholesterol ratio, a marker of cholesterol synthesis, suggesting increased cholesterol synthesis. Experiments in mice indicated that PXR activation causes widespread induction of the cholesterol synthesis genes including the rate-limiting Hmgcr and upregulates the intermediates in the Kandutsch–Russell cholesterol synthesis pathway in the liver. Additionally, PXR activation induced plasma proprotein convertase subtilisin/kexin type 9 (PCSK9), a negative regulator of hepatic LDL uptake, in both mice and humans. We propose that these effects were mediated through increased proteolytic activation of sterol regulatory element-binding protein 2 (SREBP2) in response to PXR activation. Conclusions and implications: PXR activation induces cholesterol synthesis, elevating LDL and total cholesterol in humans. The PXR–SREBP2 pathway is a novel regulator of the cholesterol and PCSK9 synthesis and a molecular mechanism for drug- and chemical-induced hypercholesterolemia.

The prevalence of metabolic diseases is paralleled by increases in exposure to foreign chemicals, e.g. drugs and environmental contaminants. Rather common for these chemicals is their ability to activate Pregnane X receptor (PXR), a master regulator of drug metabolism. PXR has been also implicated to have roles in glucose and lipid metabolism as its activation impairs glucose tolerance, increases liver fat, and modulates cholesterol metabolism. Therefore, PXR activation may in part explain the association of chemical exposure and metabolic diseases. This thesis studies the function of PXR in different metabolic states. This thesis demonstrates that fasting mitigates transcriptomic PXR activation response and modulates PXR function in bile acid metabolism. In obese and metabolically dysfunctional mice, PXR activation aggravates liver fat accumulation and hepatic insulin resistance and increases cholesterol synthesis. However, these metabolic defects do not reflect to glucose metabolism due to increased hepatic glucose uptake and suppressed fasting response, which together lead to pseudo-improvement of glucose tolerance. Induction of cholesterol synthesis was due to activation of SREBP2, the main regulator of cholesterol synthesis. Similarly, one-week dosing of rifampicin, a human PXR activator, increased hepatic cholesterol synthesis and circulating atherogenic lipids in humans. Importantly, PCSK9, a drug target to lower LDL, was increased by PXR activation. This thesis reveals that metabolic status regulates PXR function. In obese mice, PXR activation elicits different and more severe response on glucose and lipid metabolism than in lean mice. Therefore, obesity may sensitize to harmful metabolic effects of PXR activating drugs and environmental chemicals. Further, the thesis defines PXR activation as a possible risk for cardiovascular health as it increases circulating atherogenic lipids and PCSK9., Tiivistelmä Lihavuuden ja metabolisten sairauksien ilmaantuvuuden on todettu liittyvän vierasaineille, kuten lääkkeille ja ympäristökemikaaleille, altistumiseen. Monet näistä vierasaineista aktivoivat pregnaani X -reseptorin (PXR) johtaen vierasaineiden nopeampaan eliminaatioon. PXR:n aktivaatio vaikuttaa metaboliseen terveyteen haitallisesti: se heikentää sokerinsietoa, rasvoittaa maksaa, ja vaikuttaa kolesterolimetaboliaan. PXR:n aktivaatio saattaakin osaltaan selittää kemikaalialtistuksen ja metabolisten sairauksien yhteyttä. Tässä väitöstyössä tutkittiin PXR:n toimintaa erilaisissa metabolisissa tiloissa. Työssä havaittiin paaston heikentävän PXR-aktivaation vastetta ja vaikuttavan PXR:n toimintaan sappihappimetabolian säätelyssä. Lihavuuden aiheuttama metabolinen häiriötila taas herkisti hiiriä PXR-välitteiselle maksan rasvoittumiselle, heikensi maksan insuliiniherkkyyttä ja lisäsi kolesterolin synteesiä. Nämä häiriöt eivät kuitenkaan heikentäneet sokerimetaboliaa, sillä PXR:n aktivaatio lisäsi maksassa sokerin soluunottoa ja heikensi paastovastetta. PXR:n aikaansaama kolesterolisynteesin kiihtyminen johtui SREBP2:n, keskeisen kolesterolisynteesin säätelijän, aktivaatiosta. Sama synteesin kiihtyminen havaittiin terveissä vapaaehtoisissa PXR-aktivaattori rifampisiinin annon jälkeen. Rifampisiini kiihdytti PXR-välitteisesti kolesterolisynteesiä ja lisäsi valtimonkovettumatautia aiheuttavia lipidejä. Lisäksi PXR:n aktivaatio nosti plasman PCSK9-pitoisuutta, mikä lisää LDL-kolesterolin määrää. Väitöskirja osoittaa aineenvaihdunnallisen tilan, tarkoittakoon se paastoa tai aineenvaihdunnallisia sairauksia, säätelevän PXR:n toimintaa. Lihavissa hiirissä PXR on voimakas maksan sokeri- ja lipidiaineenvaihdunnan säätelijä. Lihavuus saattaakin herkistää PXR:n aktivaattorien, kuten monien lääkkeiden ja ympäristökemikaalien, metabolisille haitoille. Lisäksi väitöstyön osoittama kolesterolisynteesin ja aterogeenisten lipidien ja PCSK9:n lisääntyminen viittaa PXR:n aktivaatio

Low plasma level of 25‐hydroxyvitamin D (25‐OH‐D), namely vitamin D deficiency, is associated with obesity and weight loss improves 25‐OH‐D status. However, the mechanism behind obesity‐induced vitamin D deficiency remains unclear. Here, we report that obesity suppresses the expression of cytochrome P450 (CYP) 2R1, the main vitamin D 25‐hydroxylase, in both mice and humans. In humans, weight loss induced by gastric bypass surgery increased the expression of CYP2R1 in the s.c. adipose tissue suggesting recovery after the obesity‐induced suppression. At the same time, CYP27B1, the vitamin D 1α‐hydroxylase, was repressed by the weight loss. In a mouse (C57BL/6N) model of diet‐induced obesity, the plasma 25‐OH‐D was decreased. In accordance, the CYP2R1 expression was strongly repressed in the liver. Moreover, obesity repressed the expression of CYP2R1 in several extrahepatic tissues, the kidney, brown adipose tissue, and testis, but not in the white adipose tissue. Obesity had a similar effect in both male and female mice. In mice, obesity repressed expression of the vitamin D receptor in brown adipose tissue. Obesity also upregulated the expression of the vitamin D receptor and CYP24A1 in the s.c. adipose tissue of a subset of mice; however, no effect was observed in the human s.c. adipose tissue. In summary, we show that obesity affects CYP2R1 expression both in the mouse and human tissues. We suggest that in mouse the CYP2R1 repression in the liver plays an important role in obesity‐induced vitamin D deficiency. Currently, it is unclear whether the CYP2R1 downregulation in extrahepatic tissues could contribute to the obesity‐induced low plasma 25‐OH‐D, however, this phenomenon may affect at least the local 25‐OH‐D concentrations.

Pregnane X receptor (PXR) activation has been found to regulate glucose and lipid metabolism and affect obesity in response to high-fat diets. PXR also modulates vascular tone. In fact, PXR appears to regulate multiple components of metabolic syndrome. In most cases, the effect of PXR action is harmful to metabolic health, and PXR can be hypothesized to play an important role in metabolic disruption elicited by exposure to endocrine-disrupting chemicals. The majority of the data on the effects of PXR activation on metabolic health come from animal and cell culture experiments. However, randomized, placebo-controlled, human trials indicate that the treatment with PXR ligands impairs glucose tolerance and increases 24-h blood pressure and heart rate. In addition, plasma 4β-hydroxycholesterol (4βHC), formed under the control of PXR in the liver, is associated with lower blood pressure in healthy volunteers. Furthermore, 4βHC regulates cholesterol transporters in peripheral tissues and may activate the beneficial reverse HDL cholesterol transport. In this review, we discuss the current knowledge on the role of PXR and the PXR–4βHC axis in the regulation of components of metabolic syndrome.

Activation of pregnane X receptor (PXR) elevates circulating 4β-hydroxycholesterol (4βHC), an agonist of liver X receptor (LXR). PXR may also regulate 25-hydroxycholesterol and 27-hydroxycholesterol. Our aim was to elucidate the roles of PXR and oxysterols in the regulation of cholesterol transporters. We measured oxysterols in serum of volunteers dosed with PXR agonist rifampicin 600 mg/day versus placebo for a week and analyzed the expression of cholesterol transporters in mononuclear cells. The effect of 4βHC on the transport of cholesterol and the expression of cholesterol transporters was studied in human primary monocyte-derived macrophages and foam cells in vitro. The expression of cholesterol transporters was measured also in rat tissues after dosing with a PXR agonist. The levels of 4βHC were elevated, while 25-hydroxycholesterol and 27-hydroxycholesterol remained unchanged in volunteers dosed with rifampicin. The expression of ATP binding cassette transporter A1 (ABCA1) was induced in human mononuclear cells in vivo. The influx of cholesterol was repressed by 4βHC, as was the expression of influx transporter lectin-like oxidized LDL receptor-1 in vitro. The cholesterol efflux and the expression of efflux transporters ABCA1 and ABCG1 were induced. The expression of inducible degrader of the LDL receptor was induced. In rats, PXR agonist increased circulating 4βHC and expression of LXR targets in peripheral tissues, especially ABCA1 and ABCG1 in heart. In conclusion, PXR activation-elevated 4βHC is a signaling molecule that represses cholesterol influx and induces efflux. The PXR-4βHC-LXR pathway could link the hepatic xenobiotic exposure and the regulation of cholesterol transport in peripheral tissues.

Vitamin D deficiency, i.e., low circulating 25-hydroxyvitamin D (25(OH)D) level, has been consistently associated with the prevalence of metabolic diseases, including types 1 and 2 diabetes. However, the causal link between low vitamin D and metabolic disturbances remains uncertain. In the present thesis, I report novel findings indicating that vitamin D metabolism is under strict control by the metabolic state. Specifically, obesity represses the expression of cytochrome P450 (CYP) 2R1, the major vitamin D 25-hydroxylase responsible for the first bioactivation step in both mice and humans. Interestingly, in humans, weight loss induced by gastric bypass surgery increased CYP2R1 expression in the white adipose tissue. In mouse liver, Cyp2r1 and vitamin D bioactivation was suppressed by fasting, and both type 1 and type 2 diabetes. This may consequently cause low plasma 25(OH)D levels. On the other hand, fasting induced expression of the vitamin D catabolic enzyme CYP24A1 in the kidney. Mechanistically, we discovered that Cyp2r1 and vitamin D bioactivation are repressed by molecular pathways activated physiologically by fasting or pathologically in diabetes, namely, the peroxisome proliferator-activated receptor-gamma coactivator 1-α and estrogen-related receptor α (PGC-1α-ERRα), and the glucocorticoid receptor pathways. Moreover, the PGC-1α-ERRα pathway is crucial for mediating the Cyp24a1 induction by fasting in the kidney. In the current thesis, we uncover a molecular mechanism for the vitamin D deficiency observed in diabetic patients and reveal a novel negative feedback mechanism controlling the crosstalk between energy homeostasis and the vitamin D pathway. Importantly, our data propose that vitamin D deficiency is a consequence, and not the cause of diabetes., Tiivistelmä D-vitamiinin puutteen eli veren matalan 25-hydroksi-D-vitamiinin (25(OH)D) pitoisuuden on havaittu toistuvasti assosioituvan metabolisten sairauksien, kuten tyypin 1 ja 2 diabeteksen, ilmenemiseen. Tästä huolimatta D-vitamiinin puutteen ja metabolisten häiriöiden välinen kausaalinen yhteys on epävarma. Tässä väitöskirjatyössä raportoimme uusia löydöksiä, jotka osoittavat elimistön metabolisen tilan tehokkaasti säätelevän D-vitamiinin aineenvaihduntaa. Tarkemmin ottaen lihavuus repressoi sytokromi P450 (CYP) 2R1:ta, D-vitamiinin tärkeintä 25-hydroksylaasia ja ensimmäistä bioaktivaatiovaihetta sekä hiirissä että ihmisissä. Mielenkiintoinen havainto oli, että ihmisillä mahalaukun ohitusleikkaukseen liittyvä painonlasku sai aikaan CYP2R1:n ilmenemisen nousun valkeassa rasvakudoksessa. Hiiren maksassa sekä tyypin 1 ja 2 diabetes että paastoaminen vähensivät Cyp2r1:n ilmentymistä ja D-vitamiinin bioaktivaatiota. Tämä voi johtaa plasman 25(OH)D pitoisuuden alentumiseen. Toisaalta paastoaminen indusoi D-vitamiinin kataboliaentsyymiä, CYP24A1, munuaisessa. Mekanistisella tasolla havaitsimme, että Cyp2r1 ilmentymistä ja D-vitamiinin bioaktivaatiota estävät sellaiset molekylaariset säätelytiet, jotka aktivoituvat fysiologisesti paaston aikana ja patologisesti diabeteksessa. Tällaisia ovat peroksisomi-proliferaattori-aktivaattori-reseptori γ:n koaktivaattori 1 α:n ja estrogeeniin kaltainen reseptori α:n (PGC-1α-ERRα) sekä glukokortikoidireseptorin välittämät säätelytiet. PGC-1α-ERRα säätelee tämän lisäksi myös Cyp24a1:n induktiota munuaisessa paaston aikana. Tässä väitöskirjatyössä tunnistimme molekylaarisen mekanismin, joka selittää diabeetikoilla havaitun D-vitamiinin puutteen ja löysimme aiemmin tuntemattoman negatiivisen palautemekanismin, joka välittää energiahomeostaasin ja D-vitamiinijärjestelmän välistä vuorovaikutusta. Löydöksien perusteella voidaan tehdä tärkeä johtopäätös, että D-vitamiinin puutos on diabeteksen seuraus, ei syy.

The cytochrome P450 (CYP) enzyme family is the most important enzyme system catalyzing the phase 1 metabolism of pharmaceuticals and other xenobiotics such as herbal remedies and toxic compounds in the environment. The inhibition and induction of CYPs are major mechanisms causing pharmacokinetic drug–drug interactions. This review presents a comprehensive update on the inhibitors and inducers of the specific CYP enzymes in humans. The focus is on the more recent human in vitro and in vivo findings since the publication of our previous review on this topic in 2008. In addition to the general presentation of inhibitory drugs and inducers of human CYP enzymes by drugs, herbal remedies, and toxic compounds, an in-depth view on tyrosine-kinase inhibitors and antiretroviral HIV medications as victims and perpetrators of drug–drug interactions is provided as examples of the current trends in the field. Also, a concise overview of the mechanisms of CYP induction is presented to aid the understanding of the induction phenomena.

Low 25-hydroxyvitamin D levels correlate with the prevalence of diabetes; however, the mechanisms remain uncertain. Here, we show that nutritional deprivation–responsive mechanisms regulate vitamin D metabolism. Both fasting and diabetes suppressed hepatic cytochrome P450 (CYP) 2R1, the main vitamin D 25-hydroxylase responsible for the first bioactivation step. Overexpression of coactivator peroxisome proliferator–activated receptor γ coactivator 1-α (PGC-1α), induced physiologically by fasting and pathologically in diabetes, resulted in dramatic downregulation of CYP2R1 in mouse hepatocytes in an estrogen-related receptor α (ERRα)–dependent manner. However, PGC-1α knockout did not prevent fasting-induced suppression of CYP2R1 in the liver, indicating that additional factors contribute to the CYP2R1 repression. Furthermore, glucocorticoid receptor (GR) activation repressed the liver CYP2R1, suggesting GR involvement in the regulation of CYP2R1. GR antagonist mifepristone partially prevented CYP2R1 repression during fasting, suggesting that glucocorticoids and GR contribute to the CYP2R1 repression during fasting. Moreover, fasting upregulated the vitamin D catabolizing CYP24A1 in the kidney through the PGC-1α-ERRα pathway. Our study uncovers a molecular mechanism for vitamin D deficiency in diabetes and reveals a novel negative feedback mechanism that controls crosstalk between energy homeostasis and the vitamin D pathway.

Pregnane X receptor (PXR) regulates glucose and lipid metabolism, but little is known of the nutritional regulation of PXR function. We investigated the genome wide effects of the nutritional status on the PXR mediated gene regulation in the liver. Mice were treated with a PXR ligand pregnenolone 16α-carbonitrile (PCN) for 4 days and subsequently either fasted for 5 hours or after 4-hour fast treated with intragastric glucose 1 hour before sample collection. Gene expression microarray study indicated that PCN both induced and repressed much higher number of genes in the glucose fed mice and the induction of multiple well-established PXR target genes was potentiated by glucose. A subset of genes, including bile acid synthesis gene Cyp8b1, responded in an opposite direction during fasting and after glucose feeding. PXR knockout abolished these effects. In agreement with the Cyp8b1 regulation, PCN also modified the bile acid composition in the glucose fed mice. Contribution of glucose, insulin and glucagon on the observed nutritional effects was investigated in primary hepatocytes. However, only mild impact on PXR function was observed. These results show that nutritional status modifies the PXR regulated transcriptome both qualitatively and quantitatively and reveal a complex crosstalk between PXR and energy homeostasis.

Pregnane X receptor (PXR) is a nuclear receptor that senses chemical environment and is activated by numerous clinically used drugs and environmental contaminants. Previous studies have indicated that several drugs known to activate PXR appear to induce glucose intolerance. We now aimed to reveal the role of PXR in drug-induced glucose intolerance and characterize the mechanisms involved. We used PXR knockout mice model to investigate the significance of this nuclear receptor in the regulation of glucose tolerance. PXR ligand pregnenolone-16ɑ-carbonitrile (PCN) impaired glucose tolerance in the wildtype mice but not in the PXR knockout mice. Furthermore, DNA microarray and bioinformatics analysis of differentially expressed genes and glucose metabolism relevant pathways in PCN treated primary hepatocytes indicated that PXR regulates genes involved in glucose uptake. PCN decreased the expression of glucose transporter 2 (GLUT2) in mouse liver and in the wildtype mouse hepatocytes but not in the PXR knockout cells. Data mining of published chromatin immunoprecipitation-sequencing results indicate that Glut2 gene is a direct PXR target. Furthermore, PCN induced internalization of GLUT2 protein from the plasma membrane to the cytosol in the liver in vivo and repressed glucose uptake in the primary hepatocytes. Our results indicate that the activation of PXR impairs glucose tolerance and thus PXR represents a novel diabetogenic pathway. PXR activation dysregulates GLUT2 function by two different mechanisms. These findings may partly explain the diabetogenic effects of medications and environmental contaminants.

The Northern Finland Birth Cohort program (NFBC) is the epidemiological and longitudinal prospective general population research program, which was established to promote health and wellbeing of the population in northern Finland. The aim of present study, as a part of the NFBC program, was to analyze the blood levels of arsenic (B-As), cadmium (B-Cd), lead (B-Pb), total mercury (B-Hg) and selenium (B-Se); to compare these levels with threshold limits; to study sociodemographic factors; and to correlate these levels with calcium and haemoglobin. The study was comprised of 249 NFBC subjects, of which 123 were female and 126 were male (ages 31.1 ± 0.3 and 31.1 ± 0.4, respectively). All participants were asked to complete a questionnaire regarding diet and living habits. The geometric means (± SD) of B-As were 0.49 ± 2.80 μg/l and 0.44 ± 2.72 μg/l; B-Cd were 0.18 ± 4.02 μg/l and 0.12 ± 3.21 μg/l; B-Pb were 17.0 ± 1.8 μg/l and 9.06 ± 2.20 μg/l; B-Hg were 2.18 ± 2.02 μg/l and 1.85 ± 1.78 μg/l; and B-Se were 106.0 ± 1.3 and 94.3 ± 1.3 μg/l in males and females, respectively. Among the subjects in the present analysis, 23 % of males and 17.1 % of females had B-As levels above the ATSDR normal human levels of B-As in unexposed individuals (1.0 μg/l). The B-Pb geometric mean (12.44 μg/l) was approximately one eighth the CDC toxicological cut-off point of 100 μg/l. Twenty-one individuals (8.4 %) exceeded a B-Hg level of 5.8 μg/l. Fifty-eight females (47 %) had a B-Hg higher than 2.0 μg/l, the German Federal Environmental Agency cut-off point for women (18–69 years) who consume fish at least three times/month; therefore, their babies could be at risk of adverse effects during development.

Peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α) is a master regulator of energy metabolism and mitochondrial biology in high-energy cell types and tissues. The regulation of PGC-1α is versatile, and both transcriptional and post-transcriptional mechanisms play major roles. External stimuli affect PGC-1α-regulation which in turn adapts cellular signals to meet them. For example, conditions like fasting and diabetes mellitus (DM) are known to activate PGC-1α expression in the liver, resulting in enhanced de novo glucose production, gluconeogenesis. In the present study, the mechanisms of hepatic PGC-1α regulation and PGC-1α-regulated functions were elucidated. We found that PGC-1α was induced by oral type 2 diabetes therapeutic metformin, via AMPK and SIRT1, regulating the mitochondrial gene response, against previous assumptions. Simultaneously, gluconeogenesis was repressed by other means. Furthermore, PGC-1α upregulated the anti-inflammatory interleukin 1 receptor antagonist (IL1Rn). PGC-1α also diminished interleukin 1β-mediated inflammatory response in hepatocytes. Novel, xenobiotic and endobiotic metabolizing Cytochrome P450 enzymes regulated by PGC-1α were also identified in this thesis. CYP2A5 was induced by PGC-1α through hepatocyte nuclear factor 4α (HNF-4α) coactivation. Also, vitamin D metabolizing CYP2R1 and CYP24A1 were identified as novel genes regulated by PGC-1α, suggesting a role for PGC-1α in the regulation of active vitamin D levels. The findings presented in this thesis provide insight into the pathology of glucose perturbations such as type 2 diabetes, and stimulate discovery of therapeutic agents to treat this disease. Furthermore, the findings suggest that vitamin D metabolism and energy metabolism are tightly linked, with PGC-1α emerging as a novel mediator., Tiivistelmä Peroksisomiproliferaattori-aktivoituvan reseptori γ:n koaktivaattori 1α (PGC-1α) on merkittävä glukoosiaineenvaihdunnan ja mitokondrioiden toiminnan säätelijä korkeaenergisissä soluissa ja kudoksissa. PGC-1α:a säädellään monin tavoin: sekä transkriptionaalisella säätelyllä että transkription jälkeisellä muokkauksella on merkittävä rooli. Monet ulkoiset tekijät säätelevät PGC-1α:n aktiivisuutta, joka puolestaan säätelee solunsisäisiä signaalireittejä vastaamaan tähän signaaliin. Esimerkiksi paasto ja diabetes mellitus (DM) ovat fysiologisia tiloja, jotka lisäävät voimakkaasti PGC-1α:n ilmentymistä maksassa, jolloin glukoosin uudistuotanto eli glukoneogeneesi kiihtyy. Tässä väitöskirjassa tutkittiin PGC-1α:n säätelyä sekä PGC-1α -säädeltyjä signaalireittejä maksassa. Osoitimme, että tyypin 2 diabeteslääke metformiini indusoi PGC-1α:n ilmentymistä maksassa, vastoin aikaisempia käsityksiä. PGC-1α indusoitui AMPK:n ja SIRT1:n välityksellä, säädelleen edelleen mitokondriaalisten geenien aktiivisuutta. Samalla glukoneogeneesi kuitenkin repressoitui muilla mekanismeilla. Lisäksi osoitimme, että PGC-1α indusoi tulehdusreaktiota vaimentavaa interleukiini 1 reseptorin antagonistia (IL1Rn). PGC-1α esti interleukiini 1β:n aiheuttamaa tulehdusvastetta hepatosyyteissä. Lisäksi väitöskirjassa tunnistettiin uusia, PGC-1α -säädeltyjä lääkeaineita ja elimistön sisäisiä yhdisteitä metaboloivia sytokromi P450 -entsyymejä (CYP). Hiiren CYP2A5:n ilmentymisen osoitettiin olevan PGC-1α- ja HNF4α-välitteistä. Lisäksi osoitettiin, että D-vitamiinia metaboloivat CYP2R1 ja CYP24A1 ovat uusia PGC-1α -säädeltyjä geenejä. Tämä löydös viittaa siihen, että PGC-1α:lla on rooli aktiivisen D-vitamiinin säätelyssä. Tämän väitöskirjan löydökset lisäävät tietoa glukoosiaineenvaihdunnan häiriöiden kuten tyypin 2 diabeteksen molekulaarisista mekanismeista, joita voidaan hyödyntää mahdollisten uusien lääkeaineiden kehittämisessä. Lisäksi väitöskirjassa osoitettiin, että D-vitamiinimetabolia on ky

Peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α) and AMP-activated protein kinase (AMPK) are major factors regulating energy homeostasis. In this study, we aimed to investigate how energy flux affects several hepatic functions mediated by these factors. We define a novel role of PGC-1α and AMPK as modulators of the immune system in the liver. We show that PGC-1α is involved in the regulation of a cluster of genes related to the immune system, most importantly Interleukin 1 receptor antagonist (IL1Rn). Since PGC-1α is responsive to energetic stress associated with fasting or physical exercise, the same stimuli promote IL1Rn in hepatocytes. We identify AMPK as an independent inducer of IL1Rn and hypothesise that it could account for the anti-inflammatory effect of the antidiabetic drug metformin. We also demonstrate that metformin reduces expression of Sirtuin 3 (SIRT3) in hepatocytes and promotes acetylation of mitochondrial protein. We suggest that this mechanism, in spite of increased mitochondrial biogenesis, contributes to reduced ATP synthesis in metformin-treated samples. In addition, we demonstrate that Pregnane X receptor (PXR) is induced in the liver during fasting and by PGC-1α in hepatocytes. Furthermore, we describe a negative regulatory mechanism involving SIRT1, activated by pyruvate and interfering with PXR signaling. We show that SIRT1 attenuates PGC-1α-mediated co-activation of PXR and its target genes, i.e. Cyp3a11, with possible implications for drug and xenobiotic metabolism. In conclusion, we demonstrate how energetic stress affects various hepatic functions mediated by PGC-1α and AMPK. Moreover, we describe SIRT1 and metformin as factors capable of modulating this response., Tiivistelmä Peroksisomiproliferaattori-aktivoituvan reseptori gamman koaktivaattori 1α (PGC-1α) ja AMP:n aktivoima proteiinikinaasi (AMPK) ovat keskeisiä energiametabolian säätelijöitä. Tässä tutkimuksessa oli tavoitteena selvittää kuinka energiataso vaikuttaa useisiin, näiden tekijöiden säätelemiin maksan toimintoihin. Osoitamme että PGC-1α ja AMPK tekijöillä on ennestään tuntematon merkitys immuunijärjestelmän säätelyssä maksassa. Näytämme myös, että PGC-1α säätelee joukkoa geenejä, joiden tehtävä liittyy immuunijärjestelmään, tärkeimpänä Interleukiini 1 reseptori antagonistia (IL1Rn). Paastoon ja fyysiseen aktiivisuuteen liittyvä energiastressi aktivoi PGC-1α:aa ja näiden samojen stimuluksien havaittiin lisäävän myös IL1Rn tasoa hepatosyyteissä. Havaitsimme AMPK:n olevan itsenäinen IL1Rn indusori ja hypoteesimme mukaan tämä voi välittää diabeteslääkkeenä käytettävän metformiinin anti-inflammatorisia vaikutuksia. Osoitamme myös, että metformiini alentaa Sirtuiini (SIRT) 3:n ekspressiota maksasoluissa ja lisää mitokondriaalisten proteiinien asetylaatiota. Uskomme tämän mekanismin, huolimatta lisääntyneestä mitokondrioiden biogeneesistä, myötävaikuttavan vähentyneeseen ATP synteesiin metformiinikäsitellyissä näytteissä. Lisäksi osoitamme, että paasto ja PGC-1α indusoivat Pregnaani X reseptorin (PXR) ilmentymistä maksasoluissa. Kuvaamme myös PXR signalointiin vaikuttavan ja pyruvaatin aktivoiman, SIRT1:n välitteisen, negatiivisen säätelymekanismin. SIRT1 estää PGC-1α välitteistä PXR koaktivaatiota ja kohdegeenien, kuten Cyp3a11, aktivaatiota, millä voidaan olettaa olevan merkitystä lääkeaineiden ja vierasaineiden metaboliaan. Yhteenvetona osoitamme, että energiastressi PGC-1α:n ja AMPK:n välittämänä vaikuttaa useisiin maksan toimintoihin. Lisäksi näytämme, että SIRT1 ja metformiini voivat moduloida näitä vaikutuksia.

The hepatic inducible Cytochrome P450s (CYPs) generally prime xenobiotics for elimination. Murine CYP2A5 and human CYP2A6 share similar xenobiotic substrates and some regulatory features. Recently, they were shown to oxidize bilirubin, a byproduct of heme catabolism and a dose-dependent anti- or pro-oxidant, to biliverdin. In this study, the putative role of the redox-sensitive, cytoprotective transcription factor Nuclear factor (erythroid-derived 2)-like 2 (Nrf2) in the regulation of hepatic Cyp2a5 expression and induction under diverse hepatotoxic conditions and altered heme homeostasis was characterized. The coordination of Cyp2a5 and the Nrf2 target gene Heme oxygenase-1 (Hmox1), which determines bilirubin formation from heme, responses to heavy metals and modulators of heme homeostasis, was studied in cultured wildtype and Nrf2(-/-) mouse primary hepatocytes. Nrf2 was essential for the basal hepatic expression of CYP2A5 in the endoplasmic reticulum (ER) and mitochondria, as well as for its induction by cadmium, lead, methyl mercury and phenethyl isothiocyanate. A functional Nrf2 binding antioxidant response element (ARE) about -2.4 kilobases upstream of the Cyp2a5 transcriptional start site was identified. In contrast to Hmox1, a target of BTB and CNC homology 1 (Bach)-mediated repression via AREs, the regulation of Cyp2a5 did not clearly involve Bach1. Excessive heme induced mainly ER-localized CYP2A5 via Nrf2, which was limited by the Nrf2-independent HMOX1 induction. In heme synthesis blockades, CYP2A5 was enhanced via Nrf2 and additional factors, such as the peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α). The typical CYP2A5 inducers phenobarbital, dibutyryl-cyclic adenosine monophosphate (db-cAMP) and PGC-1α enhance heme synthesis; CYP2A5 was induced via Nrf2 in acute but not chronic phenobarbital exposure without a clear connection to heme, while the responses to db-cAMP and PGC-1α were sensitized in, Tiivistelmä Vierasaineet stimuloivat maksan Sytokromi P450 (CYP)-entsyymejä, mikä yleensä lisää niiden eliminaatiota. Hiiren CYP2A5 ja ihmisen CYP2A6 ovat lähisukua katalyyttisten ja osin säätelyllisten yhteneväisyyksiensä puolesta. Vastikään niiden osoitettiin katalysoivan hemin hajoamistuotteen, bilirubiinin hapettumista biliverdiiniksi, mikä saattaisi säädellä sen annosriippuvaisia vaikutuksia antioksidanttina ja oksidanttina. Työssä tutkittiin solustressiä aistivan, suojaavan transkriptiotekijän Nrf2 osuutta Cyp2a5-geenin aktivaatiossa maksatoksisissa olosuhteissa ja hemimetabolian muutoksissa. Cyp2a5:n ja bilirubiinin tuotosta vastaavan, Nrf2-säädellyn Hemioksigenaasi-1 (Hmox1):n vasteita verrattiin viljellyissä villityypin ja poistogeenisen Nrf2(-/-) hiiren primaarimaksasoluissa. Tulokset osoittavat, että Nrf2 ylläpitää CYP2A5:n ilmentymistä endoplasmisella kalvostolla (ER) ja mitokondrioissa sekä välittää sen stimulaation altisteilla kadmium, lyijy, metyylielohopea ja fenetyyli-isotiosyanaatti. Toimiva Nrf2-vasteinen antioksidanttivaste-elementti (ARE) tunnistettiin n. -2,4 kiloemäsparia Cyp2a5-geenin luennan aloituskohdasta ylävirtaan. BTB ja CNC homologia 1 (Bach1)-tekijä, joka on tärkeä Hmox1-säätelijä ja ARE-välitteinen transkription estäjä, ei selkeästi osallistu Cyp2a5:n säätelyyn. Hemin ylimäärä stimuloi CYP2A5:n määrää ER-kalvostolla, Nrf2-riippumattomasti stimuloituvan HMOX1 rajoittaessa Nrf2-reitin aktivaatiota. Hemisynteesin estyessä Nrf2 aktivoi Cyp2a5-geeniä muiden mekanismien kuten peroksisomiproliferaattori-aktivoituva reseptori gamman koaktivaattori-1α (PGC-1α) kanssa. Fenobarbitaali (PB), dibutyryyli-syklinen adenosiinimonofosfaatti (db-cAMP) ja PGC-1α lisäävät tunnetusti hemisynteesiä. Nrf2 havaittiin Cyp2a5:n aktivaatiolle välttämättömäksi akuutissa mutta ei kroonisessa PB-altistuksessa ilman selkeästi havaittua hemin osuutta. Cyp2a5-geenin db-cAMP- ja PGC-1α-vasteinen stimulaatio voimistui merkittävästi toimivan Nrf2-re

BACKGROUND: The ATP-dependent drug-efflux pump, P-glycoprotein (P-gp) encoded by ABCB1 (MDR1), plays a crucial role in several tissues forming blood-tissue barriers. Absence of a normally functioning P-gp can lead to a highly increased tissue penetration of a number of clinically important drugs. METHODS: We have studied the dose-response effect of exogenous ATP on the placental transfer of the well-established P-gp substrate saquinavir in 17 dually perfused human term placentas. We have also studied the influence of the ABCB1 polymorphisms 2677G>T/A and 3435C>T on placental P-gp expression (n = 44) and the transfer (n = 16) of saquinavir. RESULTS: The present results indicate that the addition of exogenous ATP to the perfusion medium does not affect the function of P-gp as measured by saquinavir transfer across the human placenta. The variant allele 3435T was associated with significantly higher placental P-gp expression than the wild-type alleles. However, neither polymorphism affected placental transfer of saquinavir nor there was any correlation between P-gp expression and saquinavir transfer. CONCLUSIONS: Our results indicate that addition of exogenous ATP is not required for ATP-dependent transporter function in a dually perfused human placenta. Although the ABCB1 polymorphism 3435C>T altered the expression levels of P-gp in the human placenta, this did not have any consequences on P-gp-mediated placental transfer of saquinavir.