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ATP8B1 Deficiency Causes Phosphodiesterase 4-Mediated Glucagon Resistance and Impaired Gluconeogenesis in Mouse and
Jung-Chin Chang1,2, Wietse In Het Panhuis2,3, Shu-Hao Hsu4
1Department of Biomolecular Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands.
Insights
ATP8B1 deficiency in progressive familial intrahepatic cholestasis type I (PFIC1) leads to impaired liver glucose regulation by upregulating PDE4D, causing glucagon resistance. This impacts gluconeogenesis and glycogenolysis in both mouse models and PFIC1 patients.
Area of Science:
- Hepatology
- Metabolic Research
- Genetics
Background:
- ATP8B1 deficiency causes progressive familial intrahepatic cholestasis type I (PFIC1).
- PFIC1 patients may exhibit metabolic dysregulation beyond cholestasis, including glucose and lipid metabolism.
- ATP8B1's role in hepatic glucose and lipid metabolism requires further investigation.
Purpose of the Study:
- To investigate the role of ATP8B1 in hepatic glucose and lipid metabolism.
- To utilize the Atp8b1G308V/G308V mutant mouse as a preclinical model for PFIC1 metabolic studies.
- To validate findings in PFIC1 patient liver samples.
Main Methods:
- Examined Atp8b1G308V/G308V and wild-type mice.
- Assessed hepatic glucose metabolism via oral glucose tolerance tests and plasma glucose/insulin/lipid quantification.
- Conducted mechanistic studies in primary mouse hepatocytes and HepG2 cells, validating with PFIC1 patient liver tissues.
Main Results:
- Atp8b1G308V/G308V mice displayed reduced fasting glucose, triglycerides, and insulin, suggesting impaired glucagon response.
- Primary mouse hepatocytes showed reduced glucagon signaling and increased Pde4 isoforms; PDE4 inhibition normalized signaling.
- PFIC1 patient livers exhibited elevated PDE4D, reduced p-CREB, and low glycogen content.
Conclusions:
- ATP8B1 deficiency upregulates hepatic PDE4D in both mouse models and PFIC1 patients.
- PDE4D-mediated glucagon resistance contributes to impaired gluconeogenesis and altered glycogenolysis.
- This study provides novel metabolic insights into ATP8B1 deficiency in PFIC1.
Background And Aims:
Deficiency of the phospholipid transporter ATP8B1 causes infantile-onset progressive familial intrahepatic cholestasis type I (PFIC1). Pre-transplant PFIC1 patients often present with mild dyslipidaemia. This raises the possibility that PFIC1 patients, besides cholestasis, may also experience defects in glucose and lipid metabolism. In this study, we aimed to investigate the role of ATP8B1 in hepatic glucose and lipid metabolism using the Atp8b1G308V/G308V mutant mouse, a pre-clinical model of PFIC1.
Methods:
Atp8b1G308V/G308V and wild-type mice on normal chow were examined. Hepatic glucose metabolism was evaluated by oral glucose tolerance testing, quantification of fasting plasma glucose, insulin and lipids. Mechanistic studies were conducted in primary mouse hepatocytes (PMHs) and HepG2 cells overexpressing glucagon receptor (HepG2-GCGR). The findings in the mouse model were validated in pre-transplant livers from PFIC1 patients.
Results:
Atp8b1G308V/G308V mice showed decreased levels of fasting blood glucose, triglycerides and insulin, indicating normal insulin sensitivity and impaired hepatic glucagon response. PMHs from Atp8b1G308V/G308V mice exhibited reduced glucagon-dependent cAMP levels and signalling and had increased expression of Pde4 isoforms. Rolipram-mediated PDE4 inhibition restored glucagon signalling. ATP8B1 knockdown HepG2-GCGR cells also showed increased PDE4D expression and impaired glucagon signalling. Liver tissue from PFIC1 patients exhibited elevated PDE4D and reduced p-CREB levels and very low glycogen content.
Conclusions:
ATP8B1 deficiency causes upregulation of PDE4D in the liver of Atp8b1G308V/G308V mice and PFIC1 patients. PDE4D-mediated glucagon resistance impairs gluconeogenesis and stimulates compensatory glycogenolysis in Atp8b1G308V/G308V mice and PFIC1 patients. Our study reveals novel metabolic insights of ATP8B1 deficiency in PFIC1 patients.
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