FXR与糖尿病相关性研究进展

国际糖尿病联盟(IDF)最新数据表明目前中国糖尿病患者在剧增。糖尿病是以胰岛素分泌相对或和绝对不足导致的慢性高血糖为特征的代谢性疾病,法尼醇X受体(farnesoid X receptor,FXR,NR1H4)是能被胆汁酸激活的转录因子,FXR能对胆汁酸的代谢进行调节,胆汁酸代谢与糖尿病相关,胆汁酸代谢在β细胞的功能是通过FXR介导的,本文回顾国内外有关法尼醇X受体通过抑制肝糖原异生、增加肝糖原储存、影响胰岛素信号、增加胰岛素的分泌和增强胰岛素的敏感性等机制发挥调节血糖平衡作用的研究,意在探索FXR与糖尿病的相关性,为糖尿病的发病机制提供新的理论依据。     

三七皂苷Ft1缓解高脂饮食引起的小鼠肥胖和胰岛素抵抗

正肥胖症是一种慢性和复杂的非传染性疾病,其特点是由于脂质平衡的破坏而导致重要代谢器官的过度脂肪沉积。它在病理学上与广泛的并发症有关,包括2型糖尿病、非酒精性脂肪肝、高血压、血脂异常、心血管疾病。目前肥胖的传统治疗方法包括生活方式干预(运动和饮食)和药物治疗,但这些方法普遍存在效果不佳的问题。因此,迫切需要制定新的干预措施,通过针对代谢调节因子来减轻肥胖的有害影响。TGR5是G蛋白偶联胆汁酸(BA)受体(又称Gpbar-1),是一种强有力的代谢调节剂,也是一种很有前途的药物靶标。TGR5广泛存在于肠道、肝脏、脂肪组织和肌肉等多代谢器官的免疫细胞和组织中,参与多种代谢过程。     

核受体FXR:一种新型代谢调节因子

法尼酯衍生物X受体(farnesoid X receptor,FXR)是一种胆汁酸受体,属于核受体超家族成员。FXR通过调控一系列基因的表达,在胆汁酸、脂质和糖代谢中发挥重要作用,进而有望成为治疗一系列代谢性疾病的药物靶点。本文将就FXR的相关研究进展作一综述。     

胆汁酸受体在非酒精性脂肪性肝病中的作用

非酒精性脂肪性肝病(non-alcoholic fatty liver disease, NAFLD)作为一种慢性肝病,在全球的发病率逐年递增。胰岛素抵抗和脂质代谢紊乱,以及随后的炎症反应和纤维化的激活,在其发生发展过程中发挥重要作用。但是对其认识仍很欠缺,且临床尚缺乏有效的药物。科研人员正极力探索NAFLD的相关病因及治疗的新的突破口。胆汁酸是在肝中合成的众多代谢产物之一。除帮助脂肪消化吸收外,胆汁酸还作为信号分子激活胆汁酸受体,一种重要的转录调节因子而发挥效应,对维持机体正常生理代谢至关重要。越来越多的证据表明,胆汁酸受体的功能与NAFLD的发生发展关系密切,研究其相关的作用与功能可为治疗NAFLD提供新见解和药物治疗靶点。本文就胆汁酸受体包括核受体,诸如法尼醇X受体 (farnesoid X receptor, FXR)、孕烷X受体 (pregnane X receptor ,PXR)等,和细胞表面受体,诸如跨膜G蛋白偶联胆汁酸受体5(transmembrane G protein-coupled receptor 5, TGR5)、鞘氨醇-1-磷酸受体2(phingosine-1-phosphate receptor 2, S1PR2)和毒蕈碱胆碱受体3 (M3 muscarinic receptor, M3R)通过调节胆汁酸稳态、脂质和糖代谢、能量代谢、肝的炎症和纤维化等参与NAFLD发病机制的研究进展进行总结,并进一步阐述了胆汁酸受体激动剂对NAFLD的治疗现状,以期更全面地了解NAFLD的发病机制以及为治疗找到更有效的途径。     

胆汁酸功能及其与肠道细菌相互关系

胆汁酸具有多种重要生理功能. 近年研究发现,胆汁酸可作为信号分子与褐色脂肪细胞表面受体TGR5结合,可激活法尼酯衍生物X受体（nuclear receptor farnesoid X receptor, FXR）的表达. 通过激活这些不同的信号传导途径,胆汁酸可以分别起到调节体内能量代谢平衡、控制肥胖以及抑制肠道细菌过度增殖的作用. 胆汁酸与人及动物肠道细菌具有复杂的相互关系：肠道细菌对于胆汁酸的转化很重要,除了在胆汁酸的转化中发挥重要作用外,肠道微生物菌群还可以十分有效地水解已被胆汁酸清除的生物体内结合寄生物或异源物质,促进这些物质的活化或肠肝循环. 宿主拥有一些抑制细菌过度增殖的机制,这些机制包括快速转运以及利用抗菌肽、蛋白水解肽和胆汁酸等进行抑菌;而有些肠道细菌在进化中形成一些抗性机制可避免胆汁酸胁迫. 本文主要就胆汁酸控制肥胖以及抑制细菌过度增殖的机制和胆汁酸与肠道细菌相互关系进行了综述.     

核受体FXR代谢调控作用及肿瘤细胞增殖机制研究进展

类法尼酯衍生物X受体(farnesoid X receptor,FXR)是配体激活的转录因子,为核受体超家族的主要成员。FXR在胆汁酸代谢、胆固醇代谢、脂代谢以及糖代谢中发挥重要作用。近期研究显示,FXR在代谢性疾病,如高糖血症和高脂血症,以及肠道炎症性疾病、肝再生,甚至肿瘤细胞的增殖和凋亡中发挥重要的调控作用。然而现阶段对于FXR的代谢调控作用在肿瘤发生、发展中的意义尚不明了,甚至存在争议。本文综述了FXR对代谢的调控作用,以及FXR对肿瘤细胞增殖的不同作用和相关机制研究的新进展。     

核受体FXR与非酒精性脂肪肝

核受体FXR也称为胆汁酸受体,调控体内胆汁酸的合成及重吸收。研究表明,FXR还与肝脏脂质代谢和糖代谢密切相关,FXR激活后可通过抑制肝脏甘油三酯合成、加速胆固醇逆向转运、抑制糖异生等多种途径缓解肝脏脂质蓄积。另外,FXR激活后还可减轻肝脏炎症和纤维化。因此,FXR可能是潜在的非酒精性脂肪肝的治疗靶点。本文将综述激活的FXR对肝脏糖脂代谢等多种通路的调控作用。     

胆汁酸的合成调控及其在生理与病理中的功能机制

胆汁酸是一类胆固醇的代谢物,在机体胆固醇与能量代谢平衡和小肠营养物质吸收等方面起着重要作用。肝脏是合成胆汁酸的主要场所。饥饿条件下,胆汁酸从肝脏分泌进入胆管并被储存到胆囊;进食后胆囊收缩,贮存的胆汁酸被排出进入小肠。在小肠中,95%的胆汁酸会被小肠重新吸收,通过肝门静脉返回肝脏,这一过程被称为胆汁酸的肝肠循环。胆汁酸一方面作为乳化剂促进小肠中脂类等物质的吸收及转运,同时也作为重要的信号分子与多种受体结合,包括核受体法呢醇X受体(farnesoidXreceptor,FXR)、维生素D受体(vitaminD receptor,VDR)、孕烷X受体(pregnaneXreceptor,PXR)以及细胞膜表面受体G蛋白偶联受体(cellmembrane surface receptor-G protein coupled receptor, TGR5)等,在调节体内胆汁酸的代谢平衡、糖脂代谢与能量代谢平衡等方面发挥重要作用。肝细胞生长因子(hepatocyte growth factor, HGF)、白介素1-(interleukin-1, IL-1)及肿瘤坏死因子(tumor necrosis factor, TNF-)等协同作用构成了胆汁酸合成的精密调控网络。本文主要综述了胆汁酸的合成调控及其功能方面的最新研究进展,旨在为胆汁酸代谢相关研究提供参考。     

类法尼醇X受体对脂代谢的调控作用

类法尼醇X受体（famesoid X receptor,FXR）属于于配体激活的核转录因子,是核受体超家族中的一员。受配体激活后．FXR在胆汁酸、脂质代谢中具有重要调控作用。随着FXR特异性配体及拮抗剂的发现,其在代谢及相关疾病中的调控作用日趋明显。最近发现,FXR在心血管系统中有表达活性,开辟了FXR调控网络的新领域。     

限制活动加剧2型糖尿病小鼠肠道菌群和糖脂代谢紊乱

【背景】久坐行为在2型糖尿病(type 2 diabetes mellitus,T2DM)患者群体中广泛存在,对于患者的血糖控制具有严重的不良影响,但是其具体机制还缺乏较为完善的阐述。【目的】通过限制小鼠活动模拟久坐行为,从而阐明久坐导致2型糖尿病小鼠糖脂代谢紊乱加剧的具体机制,为相应的健康教育和干预提供一定的理论基础。【方法】利用C57BL/6J雄性小鼠构建糖尿病模型,小鼠随机分为3组：正常组(CON)、2型糖尿病模型组(MOD)和2型糖尿病限制活动组(SED),通过限制小鼠活动的方法使其进行8周的久坐行为;采用试剂盒和形态学观察法测定小鼠糖脂代谢紊乱情况;HE和PAS染色观察小鼠回肠组织受损情况;采用RT-qPCR法测定小鼠粪便微生物的变化;采用TBA试剂盒测定小鼠血清和肝脏中总胆汁酸含量;分别通过荧光定量PCR(RT-qPCR)和Western blotting测定小鼠回肠和肝脏组织中法尼醇X受体(farnesoid X receptor,FXR)和G蛋白偶联胆汁酸受体5(G protein coupled bile acid receptor 5,TGR5)的mRNA和蛋白表达水平。【结果】与正常组相比,模型组小鼠血糖升高、血脂增加、胰岛素抵抗和口服葡萄糖耐量紊乱,而且肠道病理学变化明显,限制活动使T2DM小鼠糖脂代谢紊乱增加(P<0.05);T2DM小鼠肠道菌群失调,在门和属水平上的有益菌减少、有害菌增加,限制活动加剧了这一情况;与正常组相比,T2DM小鼠血清和肝脏组织中总胆汁酸含量增加,限制活动组总胆汁酸进一步增加(P<0.05);模型组小鼠胆汁酸受体FXR和TGR5表达较正常组显著降低(P<0.01),限制活动后进一步抑制了这些受体的表达。同时,Spearman相关性分析也显示小鼠糖脂代谢水平与肠道菌群及肠道菌群代谢物胆汁酸存在显著相关性。【结论】限制活动致使T2DM小鼠糖脂代谢紊乱加剧,其机制可能与肠道菌群和胆汁酸代谢失调,以及胆汁酸受体的进一步下调有关。     

Bile acid receptors as targets for the treatment of dyslipidemia and cardiovascular disease

Dyslipidemia is an important risk factor for cardiovascular disease (CVD) and atherosclerosis. When dyslipidemia coincides with other metabolic disorders such as obesity, hypertension, and glucose intolerance, defined as the metabolic syndrome (MS), individuals present an elevated risk to develop type 2 diabetes (T2D) as well as CVD. Because the MS epidemic represents a growing public health problem worldwide, the development of therapies remains a major challenge. Alterations of bile acid pool regulation in T2D have revealed a link between bile acid and metabolic homeostasis. The bile acid receptors farnesoid X receptor (FXR) and TGR5 both regulate lipid, glucose, and energy metabolism, rendering them potential pharmacological targets for MS therapy. This review discusses the mechanisms of metabolic regulation by FXR and TGR5 and the utility relevance of natural and synthetic modulators of FXR and TGR5 activity, including bile acid sequestrants, in the treatment of the MS.     

Glucose and insulin induction of bile acid synthesis: mechanisms and implication in diabetes and obesity

Bile acids facilitate postprandial absorption of nutrients. Bile acids also activate the farnesoid X receptor (FXR) and the G protein-coupled receptor TGR5 and play a major role in regulating lipid, glucose, and energy metabolism. Transgenic expression of cholesterol 7α-hydroxylase (CYP7A1) prevented high fat diet-induced diabetes and obesity in mice. In this study, we investigated the nutrient effects on bile acid synthesis. Refeeding of a chow diet to fasted mice increased CYP7A1 expression, bile acid pool size, and serum bile acids in wild type and humanized CYP7A1-transgenic mice. Chromatin immunoprecipitation assays showed that glucose increased histone acetylation and decreased histone methylation on the CYP7A1 gene promoter. Refeeding also induced CYP7A1 in fxr-deficient mice, indicating that FXR signaling did not play a role in postprandial regulation of bile acid synthesis. In streptozocin-induced type I diabetic mice and genetically obese type II diabetic ob/ob mice, hyperglycemia increased histone acetylation status on the CYP7A1 gene promoter, leading to elevated basal Cyp7a1 expression and an enlarged bile acid pool with altered bile acid composition. However, refeeding did not further increase CYP7A1 expression in diabetic mice. In summary, this study demonstrates that glucose and insulin are major postprandial factors that induce CYP7A1 gene expression and bile acid synthesis. Glucose induces CYP7A1 gene expression mainly by epigenetic mechanisms. In diabetic mice, CYP7A1 chromatin is hyperacetylated, and fasting to refeeding response is impaired and may exacerbate metabolic disorders in diabetes.     

The bile acid membrane receptor TGR5: a novel pharmacological target in metabolic,inflammatory and neoplastic disorders

Abstract

TGR5 is the G-protein–coupled bile acid-activated receptor, found in many human and animal tissues. Considering different endocrine and paracrine functions of bile acids, the current review focuses on the role of TGR5 as a novel pharmacological target in the metabolic syndrome and related disorders, such as diabetes, obesity, atherosclerosis, liver diseases and cancer. TGR5 ligands improve insulin sensitivity and glucose homeostasis through the secretion of incretins. The bile acid/TGR5/cAMP signaling pathway increases energy expenditure in brown adipose tissue and skeletal muscle. Activation of TGR5 in macrophages inhibits production of proinflammatory cytokines and attenuates the development of atherosclerosis. This receptor has been detected in many cell types of the liver where it has anti-inflammatory effects, thus reducing liver steatosis and damage. TGR5 also modulates hepatic microcirculation and fluid secretion in the biliary tree. In cell culture models TGR5 has been linked to signaling pathways involved in metabolism, cell survival, proliferation and apoptosis, which suggest a possible role of TGR5 in cancer development. Despite the fact that TGR5 ligands may represent novel drugs for prevention and treatment of different aspects of the metabolic syndrome, clinical studies are awaited with the perspective that they will complete TGR5 biology and identify efficient and safe TGR5 agonists.     

Endocrine functions of bile acids

Bile acids (BAs), a group of structurally diverse molecules that are primarily synthesized in the liver from cholesterol, are the chief components of bile. Besides their well-established roles in dietary lipid absorption and cholesterol homeostasis, it has recently emerged that BAs are also signaling molecules, with systemic endocrine functions. BAs activate mitogen-activated protein kinase pathways, are ligands for the G-protein-coupled receptor TGR5, and activate nuclear hormone receptors such as farnesoid X receptor alpha. Through activation of these diverse signaling pathways, BAs can regulate their own enterohepatic circulation, but also triglyceride, cholesterol, energy, and glucose homeostasis. Thus, BA-controlled signaling pathways are promising novel drug targets to treat common metabolic diseases, such as obesity, type II diabetes, hyperlipidemia, and atherosclerosis.     

Interaction of gut microbiota with dysregulation of bile acids in the pathogenesis of nonalcoholic fatty liver disease and potential therapeutic implications of probiotics

The intestinal microbiota is now recognised to play key roles in health due to its involvement in many aspects of human physiology. Disturbance in gut microbiota (dysbiosis) is thus associated with many diseases including nonalcoholic fatty liver disease (NAFLD) which includes nonalcoholic fatty liver and nonalcoholic steatohepatitis. The mechanisms for the effect of dysbiosis in NAFLD pathogenesis are not completely elucidated. Many explanations have been proposed to trigger dysbiosis, leading to NAFLD including inflammation, ethanol produced by the gut bacteria and lipotoxicity. Recently the roles of bile acids and nuclear receptors are highly regarded. It is well known that gut microbes produce enzymes that convert primary bile acids into secondary bile acids in the intestines. Several studies have demonstrated that disturbance of the intestinal microbiota leads to decreased synthesis of secondary bile acids, which in turn decreases activation of nuclear receptors such as farnesoid X receptor (FXR), pregnane X receptor, Takeda G-protein–coupled bile acid protein 5 and vitamin D receptor. These receptors are important in energy regulation and their dysregulation can cause NAFLD. Therefore, stimulation of nuclear receptors especially FXR has been extensively explored for the amelioration of NAFLD. However, paradoxical effects of nuclear receptor activation are a major problem for the clinical application of nuclear receptor stimuli. We further posit that microbiome restoration could be an alternative approach for the treatment of NAFLD. Several gut bacteria are now known to be involved in bile acid metabolism. It will be necessary to identify which one/ones is/are feasible. Careful selection of commensal bacteria for probiotics may lead to an effective therapy for NAFLD.     

Transcriptional integration of metabolism by the nuclear sterol-activated receptors LXR and FXR

Nuclear receptors are integrators of hormonal and nutritional signals, mediating changes to metabolic pathways within the body. Given that modulation of lipid and glucose metabolism has been linked to diseases including type 2 diabetes, obesity and atherosclerosis, a greater understanding of pathways that regulate metabolism in physiology and disease is crucial. The liver X receptors (LXRs) and the farnesoid X receptors (FXRs) are activated by oxysterols and bile acids, respectively. Mounting evidence indicates that these nuclear receptors have essential roles, not only in the regulation of cholesterol and bile acid metabolism but also in the integration of sterol, fatty acid and glucose metabolism.     

Targeting farnesoid X receptor for liver and metabolic disorders

The farnesoid X receptor (FXR) is a metabolic nuclear receptor expressed in the liver, intestine, kidney and adipose tissue. By regulating the expression and function of genes involved in bile acid (BA) synthesis, uptake and excretion, FXR has emerged as a key gene involved in the maintenance of cholesterol and BA homeostasis. FXR ligands are currently under clinical investigation for the treatment of cholestasis, dyslipidemic disorders and conditions of insulin resistance in type 2 diabetes and non-alcoholic steatohepatitis (NASH). Because activation of FXR impacts a considerable number of genes, development of FXR modulators that selectively regulate specific pathways will limit potentially undesirable side effects. Interaction of FXR with other BAs and xenobiotics sensors such as the constitutive androstane receptor and the pregnane X receptor might allow the development of combination therapies for liver and metabolic disorders.