成纤维细胞生长因子21:参与代谢调节的细胞因子

成纤维细胞生长因子21(FGF21)作为新近发现的内源性调节物质代谢因子,可由人体两大内分泌器官肝脏及骨骼肌分泌,其在调节代谢性疾病方面的生理作用近年来被医学界密切关注.大量研究发现FGF21可增加能量消耗、降低血浆与肝脏甘油三脂及低密度脂蛋白水平;调节葡萄糖代谢,发挥增强脂肪细胞摄取葡萄糖能力、降低血糖及抑制胰高血糖素分泌的作用.在临床2型糖尿病及非酒精性脂肪肝患者血浆中FGF21水平与对照组的显著差异具有统计学意义,且在控制其它因素后,其与病情的预后显著相关.而对于心血管病患者,FGF21可能通过其各项生理作用,拮抗心肌细胞凋亡及增强心肌抗氧化能力,一定程度上延缓心血管疾病的发生发展,但FGF21上述调节代谢相关性疾病的生理作用机制及途径目前尚不完全明确.本文简述FGF21的生物学特性及在代谢性疾病中的研究进展.     

成纤维细胞生长因子21的研究进展*

成纤维细胞生长因子21（fibroblast growth factor 21,FGF21）是一种主要的脂肪代谢调节因子,主要在肝脏中表达;FGF21有助于肝脏的脂肪代谢以及生酮反应,可以促进脂肪细胞摄取葡萄糖,促进胰岛素分泌,延缓肿瘤的发展等功能。近年来研究过程中发现,FGF21可以用于糖尿病和降血脂等其他代谢疾病治疗。主要对FGF21的特点,作用机理及其分子机制进行了概括,并对FGF21在糖尿病治疗和降血脂方面的研究进行了综述。     

FGF21对能量代谢的调控

成纤维细胞生长因子21（fibroblast growth factor 21,FGF21）作为一种不依赖胰岛素的血糖调节因子,目前已被看做是治疗2型糖尿病的一个潜在的新型治疗因素.大量鼠类及灵长类动物模型的实验结果显示：FGF21可通过作用于脂肪组织及胰腺来降低血糖和甘油三酯含量,从而预防饮食诱导的肥胖及胰岛素抵抗.此外,FGF21也被证明可作为一种主要的内源性调控子,在禁食和酮症时起着关键的调控作用.然而,一些临床观察实验的结果表明,临床观察实验与动物模型实验之间虽然具有一定的相似性,但也存在很多不同,因而目前FGF21在人体中的生理学作用仍不明确.     

血清成纤维细胞生长因子2、21、23与妊娠期糖尿病患者新生儿结局的关系

摘要 目的：探讨血清成纤维细胞生长因子2（FGF2）、成纤维细胞生长因子21（FGF21）、成纤维细胞生长因子23（FGF23）与妊娠期糖尿病（GDM）患者新生儿结局的关系。方法：选取2021年1月～2022年12月期间于我院产检的妊娠24～28周孕妇147例,均进行口服葡萄糖耐量试验（OGTT）,根据OGTT结果分为GDM组（n=86）和非GDM组（n=61）。其中GDM组根据新生儿结局分为不良组（n=21）和良好组（n=65）。对比非GDM组、GDM组的血清FGF2、FGF21、FGF23水平及新生儿结局情况。对比不良组和良好组的血清FGF2、FGF21、FGF23水平。单因素及多因素Logistic回归分析影响GDM患者新生儿结局的影响因素。结果：GDM组的血清FGF2、FGF21、FGF23水平均高于非GDM组（P<0.05）。GDM组的不良新生儿结局总发生率高于非GDM组（P<0.05）。不良组的血清FGF2、FGF21、FGF23水平均高于良好组（P<0.05）。单因素分析显示,GDM患者不良新生儿结局与年龄、孕前体质量指数（BMI）、分娩前BMI、空腹血糖（FPG）、餐后2 h血糖（2hPG）、空腹胰岛素（FINS）、胰岛素抵抗指数（HOMA-IR）有关（P<0.05）。多因素分析结果显示,年龄偏高、FPG偏高、孕前BMI偏高、2hPG偏高、分娩前BMI偏高、HOMA-IR偏高、FGF2偏高、FINS偏高、FGF21偏高、FGF23偏高均是GDM患者不良新生儿结局的危险因素（P<0.05）。结论：GDM患者血清FGF2、FGF21、FGF23水平升高,其与年龄、孕前BMI、分娩前BMI、FPG、2hPG、FINS、HOMA-IR偏高均是导致GDM患者不良新生儿结局的危险因素。     

Fibroblast growth factor (FGF)-21 signals through both FGF receptor-1 and 2

Fibroblast growth factor (FGF)-21 is a member of the FGF superfamily based on sequence homology. However, unlike most members of this family it does not show any mitogenic activity in all cell types tested. The objective of this study is to identify and characterize receptors for this molecule. Sequencing of the cDNA clones from 3T3-L1 adipocytes indicates that the only isoforms for FGFR-1 and 2 expressed in 3T3-L1 cells are 1IIIc and 2IIIc, respectively, suggesting that FGF-21 regulates glucose metabolism in 3T3-L1 adipocytes through FGFR-1IIIc and FGFR-2IIIc.     

运动调控FGF21在改善肥胖相关代谢性疾病中的作用

肥胖是糖尿病、脂肪肝、心血管疾病等慢性代谢性疾病发生发展的重要风险因素。运动可以改善肥胖,对相关代谢性疾病的预防与康复具有积极作用。成纤维细胞生长因子21 (fibroblast growth factor 21,FGF21)是一种对机体能量稳态、糖脂代谢有积极调控作用的内分泌因子,是代谢性疾病预防和治疗的有效靶点之一。FGF21抵抗是机体对FGF21反应性减弱的现象,表现为靶组织生物学效应降低,机体FGF21代偿性合成增加。这可能是由FGF21受体(fibroblast growth factor receptors,FGFRs)和β-klotho蛋白(β-klotho,KLB)表达减少或敏感性降低所致。肥胖患者常出现FGF21抵抗,改善FGF21抵抗是治疗肥胖及相关代谢性疾病的新思路。运动不仅可以增加部分组织FGF21表达量,还可以刺激FGFRs与KLB的表达来敏化FGF21的作用,改善FGF21抵抗。     

Rush to the fire: FGF21 extinguishes metabolic stress,metaflammation and tissue damage

FGF21 is a master regulator of homeostasis of local and systemic lipid, glucose and energy metabolism. Since its discovery a decade ago, significant progress has been made in understanding the basic molecular, cellular and physiological mechanisms underlying its metabolic roles, and characterizing its beneficial pharmacological activities and possible pathological roles in obesity, diabetes, dyslipidemia, fatty liver disease and their collateral complications and tissue damage. Under basal or normal conditions, FGF21 appears to play a dispensable role in metabolism. However, in response to a variety of cellular and metabolic stress, FGF21 is significantly upregulated to serve as a potent catabolic factor leading to the clearance of excessive lipids and glucose, and therefore, antagonizes metabolic and energy imbalance in a negative fashion. Furthermore, FGF21 treatment ameliorates tissue damage resulted from the harmful effects of metabolic abnormalities, which often ensue an oxidative, pro-inflammatory, inflammatory and/or immune stress state, the so-called metaflammation. Most notably, studies focusing on the liver, pancreas, cardio-vasculature and kidney have revealed its significant protective effects against the structural and functional damages induced by the obese, diabetic or other abnormal metabolic conditions. In this review, we will summarize the current progress on the roles of FGF21 against metaflammation and metabolic tissue damage.     

The fasting polypeptide FGF21 can enter brain from blood

FGF21 recently has been proposed as a missing link in the biology of fasting, raising the question of whether it directly reaches the brain. We used multiple time-regression analysis to quantify the influx rate of this polypeptide across the blood–brain barrier (BBB), size-exclusion chromatography to examine degradation, capillary depletion to differentiate entry into brain parenchyma from retention in the microvasculature, and measurement of efflux rate to determine a possible confounding effect on measurement of entry. FGF21 was 94% intact in serum and 75% in brain 10 min after intravenous bolus delivery. Its influx rate was 0.23 ± 0.12 μl/g-min, nearly four times faster than that of the vascular marker albumin. At 10 min, about 0.5% of the administered FGF21 was present in a gram of brain tissue. Of this, 70% reached the parenchyma of the brain. Co-injection of excess FGF21 failed to inhibit the influx, showing a lack of saturation. Efflux, which occurred at the same rate as the bulk reabsorption of cerebrospinal fluid, also was not saturable. In summary, FGF21 shows significant, non-saturable, unidirectional influx across the BBB.     

精氨酸修饰成纤维细胞生长因子21及修饰后蛋白体内稳定性和糖代谢调节作用的研究

成纤维细胞生长因子21(fibroblast growth factor21,FGF21)是2000年发现的一个不依赖胰岛素调节血糖的细胞因子,有望成为治疗糖尿病的候选药物.但是,野生型FGF21由于半衰期较短,在体内不稳定,从而影响其成药性.为提高FGF21的稳定性,本实验在FGF21的C端添加了2个精氨酸(arginine,Arg),命名为FGF21-2A,用Compute pI/Mw软件计算之后,等电点(isoelectric point,pI)从5.43上升到5.84,随后进行了蛋白质的表达、分离纯化、体内稳定性及糖代谢调节作用的研究.诱导表达后菌液的SDS-PAGE图经BandScan5.0分析后显示FGF21-2A的表达量相对于野生型FGF21提高了10.6%.家兔体内半衰期检测实验结果显示FGF21-2A的半衰期显著延长.GOD-POD法检测HepG2肝癌细胞葡萄糖吸收实验、糖尿病小鼠降血糖实验和肝糖原检测实验的结果证明,FGF21-2A的降糖效果得到了增强,并且持续时间相对于野生型FGF21显著延长.Real-time PCR结果发现,长期注射FGF21-2A显著提高了糖尿病小鼠肝脏内葡萄糖转运蛋白(GLUT)1和葡萄糖激酶(GK)mRNA的表达量,降低了葡萄糖-6-磷酸酶(G6P)的mRNA表达量,表明FGF21-2A调节糖代谢的机制与野生型FGF21一致.综上所述,精氨酸修饰的FGF21其蛋白质稳定性提高,进而增加了对血糖的调控效果,有望成为新型糖尿病药物.     

成纤维细胞生长因子21对糖脂代谢调控的研究进展

成纤维细胞生长因子21(FGF21)是成纤维细胞生长因子(FGF)家族中的一员。由于它在改善能量代谢方面的积极作用,近年来获得了广泛的关注。FGF21可作用于多个组织参与调控糖脂代谢:减轻体重,改善肥胖、糖尿病等病理情况下的高血糖及高血脂;此外,FGF21在调节饥饿等特殊生理状态的能量代谢中也起着重要的作用。本文就FGF21调控糖脂代谢的研究进展作一综述,以便更好地理解其作用机制,为慢性代谢性疾病的防治提供依据。     

不同活动、饥饿和饮食成分状态下FGF21的动力学表达

成纤维细胞生长因子21（fibroblast growth factor,FGF21）是FGF家族中的新成员．目前研究显示,FGF21是一个新的糖脂代谢调节因子,有望成为治疗糖尿病的新型药物．为探讨FGF21的生理功能,利用real-time PCR和Western印迹,检测FGF21在不同生理或病理状态下基因水平和蛋白水平的表达量变化规律．实验结果显示,在全天24 h中,小鼠肝脏中FGF21在晚18点至21点,表达量显著升高,这可能与啮齿类动物傍晚活动加强及进食习性有关|FGF21在饥饿后表达量显著升高,在饥饿后喂食FGF21的表达量下降,并且随着饥饿时间的延长,FGF21的表达量升高,说明FGF21与饥饿程度呈正相关|灌注葡萄糖后20 min内,FGF21的表达量下降,而灌注脂肪乳20 min内,FGF21的表达量上升,说明葡萄糖是FGF21的负调节因子,而脂肪乳是FGF21的正调节因子|利用谷氨酸钠造模的肥胖小鼠,肝脏中FGF21的表达量显著高于同龄对照组,说明肥胖可诱导FGF21高表达．综上所述,FGF21的表达量变化与小鼠夜间活动取食、饥饿程度、饮食中不同的成分以及肥胖有关.     

Fibroblast growth factor 21 (FGF21) inhibits chondrocyte function and growth hormone action directly at the growth plate

Fibroblast growth factor 21 (FGF21) modulates glucose and lipid metabolism during fasting. In addition, previous evidence indicates that increased expression of FGF21 during chronic food restriction is associated with reduced bone growth and growth hormone (GH) insensitivity. In light of the inhibitory effects on growth plate chondrogenesis mediated by other FGFs, we hypothesized that FGF21 causes growth inhibition by acting directly at the long bones' growth plate. We first demonstrated the expression of FGF21, FGFR1 and FGFR3 (two receptors known to be activated by FGF21) and β-klotho (a co-receptor required for the FGF21-mediated receptor binding and activation) in fetal and 3-week-old mouse growth plate chondrocytes. We then cultured mouse growth plate chondrocytes in the presence of graded concentrations of rhFGF21 (0.01-10 μg/ml). Higher concentrations of FGF21 (5 and 10 μg/ml) inhibited chondrocyte thymidine incorporation and collagen X mRNA expression. 10 ng/ml GH stimulated chondrocyte thymidine incorporation and collagen X mRNA expression, with both effects prevented by the addition in the culture medium of FGF21 in a concentration-dependent manner. In addition, FGF21 reduced GH binding in cultured chondrocytes. In cells transfected with FGFR1 siRNA or ERK 1 siRNA, the antagonistic effects of FGF21 on GH action were all prevented, supporting a specific effect of this growth factor in chondrocytes. Our findings suggest that increased expression of FGF21 during food restriction causes growth attenuation by antagonizing the GH stimulatory effects on chondrogenesis directly at the growth plate. In addition, high concentrations of FGF21 may directly suppress growth plate chondrocyte proliferation and differentiation.     

Fibroblast Activation Protein Cleaves and Inactivates Fibroblast Growth Factor 21

FGF21 is a stress-induced hormone with potent anti-obesity, insulin-sensitizing, and hepatoprotective properties. Although proteolytic cleavage of recombinant human FGF21 in preclinical species has been observed previously, the regulation of endogenously produced FGF21 is not well understood. Here we identify fibroblast activation protein (FAP) as the enzyme that cleaves and inactivates human FGF21. A selective chemical inhibitor, immunodepletion, or genetic deletion of Fap stabilized recombinant human FGF21 in serum. In addition, administration of a selective FAP inhibitor acutely increased circulating intact FGF21 levels in cynomolgus monkeys. On the basis of our findings, we propose selective FAP inhibition as a potential therapeutic approach to increase endogenous FGF21 activity for the treatment of obesity, type 2 diabetes, non-alcoholic steatohepatitis, and related metabolic disorders.     

Dynamic folding modulation generates FGF21 variant against diabetes

Fibroblast growth factor 21 (FGF21) is a regulator of glucose and lipid metabolism. It has been widely considered as a promising candidate for the treatment of type 2 diabetes mellitus (T2DM) and other related metabolic disorders. However, lack of structural and dynamic information has limited FGF21‐based drug development. Here, using nuclear magnetic resonance (NMR) spectroscopy, we determine the structure of FGF21 and find that its non‐canonical flexible β‐trefoil conformation affects the folding of β2‐β3 hairpin and further overall protein stability. To modulate folding dynamics, we designed an FGF21‐FGF19 chimera, FGF21^SS. As expected, FGF21^SS shows better thermostability without inducing hepatocyte proliferation. Functional characterization of FGF21^SS shows its better insulin sensitivity, reduced inflammation in 3T3‐L1 adipocytes, and lower blood glucose and insulin levels in ob/ob mice compared with wild type. Our dynamics‐based rational design provides a promising approach for FGF21‐based therapeutic development against T2DM.     

FGF21 suppresses alcohol consumption through an amygdalo-striatal circuit

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Passive heat loading links lipolysis and regulation of fibroblast growth factor-21 in humans

There is relativley little information on the serum biomarkers of heat stress. Therefore, the goal of this study was to verify the effect of passive heat loading (PHL) on the expression of fibroblast growth factor-21 (FGF21) and free fatty acids (FFAs). Four PHL protocols based on intensity (39 °C vs. 43 °C, leg immersion, 30 min) and type (leg vs. half immersion, 42 °C, 30 min) were used. Each protocol was applied on a 2 day cycle to 12 healthy adult males (age, 22.4±2.9 years; height, 174.1±4.6 cm; weight, 71.3±5.6 kg; body mass index, 23.1±3.0). The subjects were categorized into two groups according to the study design (randomized, with a parallel trial). Body temperature, FGF21 and FFAs were determined prior to PHL, immediately and 60 min after PHL. Body temperature was significant higher (43 °C) than the 39 °C measured under identical PHL type (leg immersion). PHL was effective for the expression of FGF21 and for lipolysis. The quantitative levels of FGF21 and FFA increased with increasing temperature (39 °C<42 °C<43 °C). A significant difference in the quantitative levels of FGF21 and FFAs was also evident based on the type of PHL (leg<half immersion) even when PHL was applied at the same temperature (42 °C). In conclusion, PHL was effective for expressing FGF21 and for lipolysis. Therefore, PHL may be expected to help in the reduction of body fat. Additionally, when the identical type (leg immersion) of PHL is applied, a loading temperature of 43 °C is more effective for expressing FGF21 and for lipolysis than temperatures of 39 °C and 42 °C, and half immersion is more effective than leg immersion at 42 °C.     

Serum concentrations of fibroblast growth factor 21 are elevated in patients with congenital or acquired lipodystrophy

ObjectivePatients with lipodystrophy (LD) suffer from loss of subcutaneous adipose tissue accompanied by dysregulation of several adipocyte-secreted factors. However, regulation of adipocyte-expressed fibroblast growth factor (FGF) 21 which acts in an insulin-mimetic, lipid-lowering, and anti-atherogenic manner has not been investigated in non-human immunodeficiency virus (HIV) LD.Material and methodsCirculating serum FGF21 levels were quantified in 37 patients with non-HIV LD and 37 controls matched for age, gender, and body mass index. Moreover, FGF21 plasma levels and mRNA expression were measured in LD mice and control animals. Additionally, serum FGF21 levels were assessed in 10 LD patients before and during metreleptin therapy.ResultsMedian FGF21 serum concentrations were significantly higher in LD patients (381.2 ng/l) as compared to the control group (231.2 ng/l; p = 0.023). There was an independent and positive association between circulating FGF21 and serum triglycerides (TG), as well as fibrate treatment, in multiple linear regression analysis. LD mice showed significantly upregulated FGF21 plasma levels (4.5-fold), as well as mRNA expression in various adipose tissue depots and liver as compared to controls (p < 0.05). Metreleptin treatment did not significantly alter circulating FGF21 levels in human subjects.ConclusionsSerum concentrations of FGF21 are elevated in patients with non-HIV LD with adipose tissue and liver being potential sources of increased production. TG and fibrate treatment are independent positive predictors of circulating FGF21.     

Oral bezafibrate induces daily torpor and FGF21 in mice in a PPAR alpha dependent manner

Fibroblast growth factor 21 (FGF21) is a hormone released from the liver that mediates many of the physiological responses of fasting, such as lipolysis and ketogenesis. FGF21 is induced by the nuclear receptor PPARα when bound to its endogenous agonist, free fatty acid, or to the synthetic agonist, bezafibrate. To determine whether PPARα agonists mediate the metabolic suppression and accompanying fall in body temperature (T_b) in a bout of torpor that occurs in mice in response to fasting, C57Bl/6J mice (wildtype) and PPARα −/− mice were implanted with temperature telemeters and fed either a control (CON) diet or one containing a PPARα agonist, bezafibrate (BEZA), for 2 weeks, followed by a fast. Wildtype mice on the BEZA diet had a striking phenotype: most entered spontaneous torpor bouts without caloric restriction towards the end of the 2 weeks. This is the first demonstration that an additive to food could induce spontaneous bouts of daily torpor. However, PPARα −/− did not express this phenotype. Moreover, wildtype mice on the BEZA diet had twice the length of torpor bouts in response to a fast as did wildtype mice on the CON diet. PPARα −/− mice did enter bouts of fasting-induced torpor, but these were unaffected by the BEZA diet. The BEZA diet induced the level of FGF21 in the blood to fasting levels only in wildtype mice. Collectively, these findings suggest that a BEZA diet mimics the fasted state in both induction of FGF21 and in thermoregulation and does so in a pathway dependent on PPARα.