The multidrug resistance-associated protein 2 (MRP2, ABCC2), mediates the efflux of several conjugated compounds across the apical membrane of the hepatocyte into the bile canaliculi. We identified MRP2 in a screen designed to isolate genes that are regulated by the farnesoid X-activated receptor (FXR, NR1H4). MRP2 mRNA levels were induced following treatment of human or rat hepatocytes with either naturally occurring (chenodeoxycholic acid) or synthetic (GW4064) FXR ligands. In addition, we have shown that MRP2 expression is regulated by the pregnane X receptor (PXR, NR1I2) and constitutive androstane receptor (CAR, NR1I3). Thus, treatment of rodent hepatocytes with PXR or CAR agonists results in a robust induction of MRP2 mRNA levels. The dexamethasone-and pregnenolone 16␣-carbonitrile-dependent induction of MRP2 expression was not evident in hepatocytes derived from PXR null mice. In contrast, induction of MRP2 by phenobarbital, an activator of CAR, was comparable in wild-type and PXR null mice. An unusual 26-bp sequence was identified 440 bp upstream of the MRP2 transcription initiation site that contains an everted repeat of the AGTTCA hexad separated by 8 nucleotides (ER-8). PXR, CAR, and FXR bound with high affinity to this element as heterodimers with the retinoid X receptor ␣ (RXR␣, NR2B1). Luciferase reporter gene constructs containing 1 kb of the rat MRP2 promoter were prepared and transiently transfected into HepG2 cells. Luciferase activity was induced in a PXR-, CAR-, or FXR-dependent manner. Furthermore, the isolated ER-8 element was capable of conferring PXR, CAR, and FXR responsiveness on a heterologous thymidine kinase promoter. Mutation of the ER-8 element abolished the nuclear receptor response. These studies demonstrate that MRP2 is regulated by three distinct nuclear receptor signaling pathways that converge on a common response element in the 5-flanking region of this gene.Members of the nuclear receptor superfamily of ligand-activated transcription factors have critical roles in many aspects of development and adult physiology, including cholesterol homeostasis, bile acid biosynthesis and transport, and xenobiotic metabolism. Recently, two orphan nuclear receptors, the farnesoid X-activated receptor (FXR, 1 NRIH4) and the pregnane X receptor (PXR, NR1I2) were shown to be activated by an overlapping spectrum of bile acids (1-5). These results indicate that bile acids function as hormonal ligands, in addition to their well established roles in the solubilization and absorption of lipids and fat-soluble vitamins from the intestinal lumen.

The farnesoid X receptor (FXR) functions as a bile acid (BA) sensor coordinating cholesterol metabolism, lipid homeostasis, and absorption of dietary fats and vitamins. However, BAs are poor reagents for characterizing FXR functions due to multiple receptor independent properties. Accordingly, using combinatorial chemistry we evolved a small molecule agonist termed fexaramine with 100-fold increased affinity relative to natural compounds. Gene-profiling experiments conducted in hepatocytes with FXR-specific fexaramine versus the primary BA chenodeoxycholic acid (CDCA) produced remarkably distinct genomic targets. Highly diffracting cocrystals (1.78 A) of fexaramine bound to the ligand binding domain of FXR revealed the agonist sequestered in a 726 A(3) hydrophobic cavity and suggest a mechanistic basis for the initial step in the BA signaling pathway. The discovery of fexaramine will allow us to unravel the FXR genetic network from the BA network and selectively manipulate components of the cholesterol pathway that may be useful in treating cholesterol-related human diseases.

Syndecan-1 (SDC1), a transmembrane heparan sulfate proteoglycan that participates in the binding and internalization of extracellular ligands, was identified in a screen designed to isolate genes that are regulated by the farnesoid X-receptor (FXR, NR1H4). Treatment of human hepatocytes with either naturally occurring (chenodeoxycholic acid) or synthetic (GW4064) FXR ligands resulted in both induction of SDC1 mRNA and enhanced binding, internalization, and degradation of low density lipoprotein. Transient transfection assays, using wild-type and mutant SDC1 promoter-luciferase genes, led to the identification of a nuclear hormone receptor-binding hexad arranged as a direct repeat separated by one nucleotide (DR-1) in the proximal promoter that was necessary and sufficient for activation by FXR. The wild-type, but not a mutated DR-1 element, conferred FXR responsiveness to a heterologous thymidine kinase promoter-reporter gene. Four murine FXR isoforms have been identified recently that differ either at their amino terminus and/or by the presence or absence of four amino acids in the hinge region. Interestingly, the activities of the human SDC1 promoter-reporter constructs were highly induced by the two FXR isoforms that do not contain the four-amino acid insert and were unresponsive to the isoforms containing the four amino acids. Thus, current studies demonstrate that hepatic SDC1 is induced in an FXR isoform-specific manner. Increased expression of SDC1 may account in part for the hypotriglyceridemic effect that can result from the administration of chenodeoxycholic acid to humans.

Affymetrix microarray data and Northern blot assays demonstrated that phospholipid transfer protein (PLTP) was induced 6-fold when either murine or human macrophages were incubated in the presence of ligands for the liver X receptor (LXR) and the retinoid X receptor. Two functional LXR response elements (LXREs) were identified and characterized in the proximal promoter of the human PLTP gene. One LXRE corresponds to a traditional direct repeat separated by 4 bp. However, the second LXRE is novel in that it corresponds to an inverted repeat separated by 1 bp, and is identical to the farnesoid X receptor response element. These studies demonstrate that PLTP is a direct target for activated LXR and farnesoid X receptor (FXR). In addition, apolipoprotein E (apoE), a known LXR target gene in macrophages, was shown to be activated in liver cells by FXR ligands.Taken together, the current data suggest that a small number of genes that currently include PLTP, apoE, and apoC-II, are induced in macrophages by activated LXR and in liver by activated FXR. Phospholipid transfer protein (PLTP) is a member of the lipid transfer/lipopolysaccharide binding protein gene family that includes CETP, the lipopolysaccharide binding protein, and the bactericidal/permeability increasing protein (1). PLTP has broad substrate specificity and functions to transfer phospholipids from triglyceride rich particles (VLDL and chylomicrons) to HDL during lipoprotein lipolysis (2). PLTP mRNA is expressed in a number of tissues, including liver, ovary, thymus, and placenta (3). Recent studies have demonstrated that PLTP is a target gene for activated farnesoid X receptor (FXR) (4, 5). This conclusion was based on the findings that i ) FXR ligands induced PLTP mRNA levels in cultured human hepatocytes (4) and in the livers of wild type but not FXR null mice (6), and ii ) the proximal promoter of the human gene contains a functional FXR response element (FXRE) (4, 5).In the current report, we utilized murine and human macrophages to demonstrate that PLTP is also an liver X receptor (LXR) target gene. Since macrophages do not express FXR, the results demonstrate that PLTP can be regulated independently by either receptor. Apolipoprotein E (apoE) is a known LXR target gene in macrophages (7,8). We now demonstrate that the hepatic expression of apoE is induced by FXR ligands. Taken together, these studies provide evidence that a subset of genes, which currently includes PLTP, apoE, and apoC-II (4-8), are induced following activation of LXR or FXR and control lipid metabolism. EXPERIMENTAL PROCEDURES Reagents, RNA isolation, Northern blot analysis, transient transfections, and reporter gene assaysExpression plasmids, sources of all reagents, and the indicated procedures have been described (6, 7, 9, 10). T0901317, chenodeoxycholate (CDCA), LG100153 (LG), and GW4064 (GW) were obtained from Cayman Chemical (Ann Arbor, MI), Sigma (St. Louis, MO), Dr. R. Heyman (Ligand Pharmaceuticals, La Jolla, CA), and Dr. T. Willson (GlaxoSmithKline), respectivel...

During the last three years there have been a plethora of publications on the liver X-activated receptors (LXR ␣ , NR1H3, and LXR ␤ , NR1H2), the farnesoid X-activated receptor (FXR, NR1H4), and the pregnane X receptor (PXR, NR1I2) and the role these nuclear receptors play in controlling cholesterol, bile acid, lipoprotein and drug metabolism. The current interest in these nuclear receptors is high, in part, because they appear to be promising therapeutic targets for new drugs that have the potential to control lipid homeostasis. In this review we emphasize i ) the role of LXR in controlling many aspects of cholesterol and fatty acid metabolism, ii ) the expanded role of FXR in regulating genes that control not only bile acid metabolism but also lipoprotein metabolism, and iii ) the regulation of bile acid transport/metabolism in response to bile acid-activated