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Differential effects of FXR or TGR5 activation in cholangiocarcinoma progression
Authors:O. Erice,I. Labiano,A. Arbelaiz,A. Santos-Laso,P. Munoz-Garrido,R. Jimenez-Agüero,P. Olaizola,A. Caro-Maldonado,N. Martín-Martín,A. Carracedo,E. Lozano,J.J. Marin,C.J. O&#x  Rourke,J.B. Andersen,J. Llop,V. Gómez-Vallejo,D. Padro,A. Martin,J.M. Banales
Affiliation:1. Department of Liver and Gastrointestinal Diseases, Biodonostia Research Institute, Donostia University Hospital, University of the Basque Country (UPV/EHU), San Sebastián, Spain;2. National Institute for the Study of Liver and Gastrointestinal Diseases (CIBERehd, Instituto de Salud Carlos III), Madrid, Spain;3. Biotech Research and Innovation Centre (BRIC), Department of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark;4. CIC bioGUNE, Bizkaia Technology Park, Derio, Spain;5. CIBERONC, Instituto de Salud Carlos III, Madrid, Spain;6. Biochemistry and Molecular Biology Department, University of the Basque Country (UPV/EHU), Bilbao, Spain;7. IKERBASQUE, Basque Foundation for Science, Bilbao, Spain;8. Experimental Hepatology and Drug Targeting (HEVEFARM), Biomedical Research Institute of Salamanca (IBSAL), University of Salamanca, Spain;9. Molecular Imaging Unit, CIC biomaGUNE, San Sebastián, Spain;10. Department of Gastroenterology, Università Politecnica delle Marche, Ancona, Italy;11. Intercept Pharmaceuticals, New York, USA;12. Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Austria
Abstract:

Background and aims

Cholangiocarcinoma (CCA) is an aggressive tumor type affecting cholangiocytes. CCAs frequently arise under certain cholestatic liver conditions. Intrahepatic accumulation of bile acids may facilitate cocarcinogenic effects by triggering an inflammatory response and cholangiocyte proliferation. Here, the role of bile acid receptors FXR and TGR5 in CCA progression was evaluated.

Methods

FXR and TGR5 expression was determined in human CCA tissues and cell lines. An orthotopic model of CCA was established in immunodeficient mice and tumor volume was monitored by magnetic resonance imaging under chronic administration of the specific FXR or TGR5 agonists, obeticholic acid (OCA) or INT-777 (0,03% in chow; Intercept Pharmaceuticals), respectively. Functional effects of FXR or TGR5 activation were evaluated on CCA cells in vitro.

Results

FXR was downregulated whereas TGR5 was upregulated in human CCA tissues compared to surrounding normal liver tissue. FXR expression correlated with tumor differentiation and TGR5 correlated with perineural invasion. TGR5 expression was higher in perihilar than in intrahepatic CCAs. In vitro, FXR was downregulated and TGR5 was upregulated in human CCA cells compared to normal human cholangiocytes. OCA halted CCA growth in vivo, whereas INT-777 showed no effect. In vitro, OCA inhibited CCA cell proliferation and migration which was associated with decreased mitochondrial energy metabolism. INT-777, by contrast, stimulated CCA cell proliferation and migration, linked to increased mitochondrial energy metabolism.

Conclusion

Activation of FXR inhibits, whereas TGR5 activation may promote, CCA progression by regulating proliferation, migration and mitochondrial energy metabolism. Modulation of FXR or TGR5 activities may represent potential therapeutic strategies for CCA.
Keywords:BA  bile acid  CCA  cholangiocarcinoma  DMEM  Dulbecco's modified Eagle's medium  FBS  fetal bovine serum  FXR  farnesoid X receptor  GAPDH  glyceraldehyde-3-phosphate dehydrogenase  GPBAR1 (or TGR5)  G protein-coupled bile acid receptor 1  MRI  magnetic resonance imaging  NASH  non-alcoholic steatohepatitis  NHC  normal human cholangiocyte  OCA  obeticholic acid  OCR  Oxygen Consumption Rate  PCNA  proliferating cell nuclear antigen  PBC  primary biliary cholangitis  PSC  primary sclerosing cholangitis  P/S  penicillin/streptomycin  qPCR  quantitative polymerase chain reaction  SEM  standard error of the mean  TLCA  taurolithocholic acid  Cholangiocarcinoma (CCA)  FXR  TGR5  Bile acids  Therapy
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