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Downregulation of TGR5 (GPBAR1) in biliary epithelial cells contributes to the pathogenesis of sclerosing cholangitis
Open accessAbstract
Background & Aims Primary sclerosing cholangitis (PSC) is characterized by chronic inflammation and progressive fibrosis of the biliary tree. The bile acid receptor TGR5 (GPBAR1) is found on biliary epithelial cells (BECs), where it promotes secretion, proliferation and tight junction integrity. Thus, we speculated that changes in TGR5-expression in BECs may contribute to PSC pathogenesis. Methods TGR5-expression and -localization were analyzed in PSC livers and liver tissue, isolated bile ducts and BECs from Abcb4 -/- , Abcb4 -/- / Tgr5 Tg and ursodeoxycholic acid (UDCA)- or 24-norursodeoxycholic acid (norUDCA)-fed Abcb4 -/- mice. The effects of IL8/IL8 homologues on TGR5 mRNA and protein levels were studied. BEC gene expression was analyzed by single-cell transcriptomics (scRNA-seq) from distinct mouse models. Results TGR5 mRNA expression and immunofluorescence staining intensity were reduced in BECs of PSC and Abcb4 -/- livers, in Abcb4 -/- extrahepatic bile ducts, but not in intrahepatic macrophages. No changes in TGR5 BEC fluorescence intensity were detected in liver tissue of other liver diseases, including primary biliary cholangitis. Incubation of BECs with IL8/IL8 homologues, but not with other cytokines, reduced TGR5 mRNA and protein levels. BECs from Abcb4 -/- mice had lower levels of phosphorylated Erk and higher expression levels of Icam1, Vcam1 and Tgfβ2. Overexpression of Tgr5 abolished the activated inflammatory phenotype characteristic of Abcb4 -/- BECs. NorUDCA-feeding restored TGR5-expression levels in BECs in Abcb4 -/- livers. Conclusions Reduced TGR5 levels in BECs from patients with PSC and Abcb4 -/- mice promote development of a reactive BEC phenotype, aggravate biliary injury and thus contribute to the pathogenesis of sclerosing cholangitis. Restoration of biliary TGR5-expression levels represents a previously unknown mechanism of action of norUDCA. Lay summary Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease-associated with progressive inflammation of the bile duct, leading to fibrosis and end-stage liver disease. Bile acid (BA) toxicity may contribute to the development and disease progression of PSC. TGR5 is a membrane-bound receptor for BAs, which is found on bile ducts and protects bile ducts from BA toxicity. In this study, we show that TGR5 levels were reduced in bile ducts from PSC livers and in bile ducts from a genetic mouse model of PSC. Our investigations indicate that lower levels of TGR5 in bile ducts may contribute to PSC development and progression. Furthermore, treatment with norUDCA, a drug currently being tested in a phase III trial for PSC, restored TGR5 levels in biliary epithelial cells.
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“Impaired TGR5 expression and signalling may contribute to the pathogenesis of cholangiopathies such as PBC and PSC, since TGR5 also protects cholangiocytes by stimulating bicarbonate secretion.48 49”
From Novel therapeutic targets for cholestatic and fatty liver disease (2022) · cites this paper as [49]
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Metadata
- Authors
- Reich, M., Spomer, L., Klindt, C., Fuchs, K., Stindt, J., Deutschmann, K., Höhne, J., Liaskou, E., Hov, J. R., Karlsen, T. H., Beuers, U., Verheij, J., Ferreira-Gonzalez, S., Hirschfield, G., Forbes, S. J., Schramm, C., Esposito, I., Nierhoff, D., Fickert, P., Fuchs, C. D., Trauner, M., García-Beccaria, M., Gabernet, G., Nahnsen, S., Mallm, J.-P., Vogel, M., Schoonjans, K., Lautwein, T., Köhrer, K., Häussinger, D., Luedde, T., Heikenwalder, M., & Keitel, V.
- Affiliations
- Düsseldorf University Hospital (DE)
- University Hospitals Birmingham NHS Foundation Trust (GB)
- Oslo University Hospital (NO)
- Amsterdam UMC Location University of Amsterdam (NL)
- Toronto General Hospital (CA)
- MRC Centre for Regenerative Medicine (GB)
- University Medical Center Hamburg-Eppendorf (DE)
- University of Cologne (DE)
- Medical University of Graz (AT)
- Medical University of Vienna (AT)
- Quantitative Biology Center (DE)
- German Cancer Research Center (DE)
- École Polytechnique Fédérale de Lausanne (CH)
- Heinrich Heine University Düsseldorf (DE)
- Corresponding author
- Keitel, Verena
- ORCID
- Reich, Maria
- Klindt, Caroline
- Fuchs, Katharina
- Stindt, Jan
- Liaskou, Evaggelia
- Hov, Johannes R.
- Karlsen, Tom H.
- Beuers, Ulrich
- Verheij, Joanne
- Ferreira-Gonzalez, Sofia
- Hirschfield, Gideon
- Forbes, Stuart J.
- Schramm, Christoph
- Esposito, Irene
- Nierhoff, Dirk
- Fickert, Peter
- Fuchs, Claudia Daniela
- Trauner, Michael
- Gabernet, Gisela
- Nahnsen, Sven
- Mallm, Jan-Philipp
- Schoonjans, Kristina
- Lautwein, Tobias
- Köhrer, Karl
- Häussinger, Dieter
- Luedde, Tom
- Keitel, Verena
- Venue
- Journal of Hepatology
- Publisher
- Elsevier BV
- Published
- 2021-09
- Volume
- 75
- Issue
- 3
- Pages
- 634-646
- ISSN
- 0168-8278 (ISSN-L)
- OpenAlex
- W3154248475
- Cited by
- 121
- References
- 53
- Citations by year
- 2026: 20 · 2025: 29 · 2024: 29 · 2023: 26 · 2022: 10 · 2021: 7
- FWCI
- 9.99
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Journal of Hepatology (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Kölner Universitäts PublikationsServer (Universität zu Köln) (publishedVersion)
- Pure Amsterdam UMC (publishedVersion, cc-by)
- Infoscience (Ecole Polytechnique Fédérale de Lausanne) (submittedVersion, cc-by-nc-nd)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by-nc-nd)
- NORA - Norwegian Open Research Archives (submittedVersion, cc-by-nc-nd)
- Funders
- Wilhelm Sander Foundation
- European Commission
- German Cancer Aid
- German Research Foundation
- Research Foundation Flanders
- Topics
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Health Sciences › Medicine › Oncology › Drug Transport and Resistance Mechanisms
- Health Sciences › Medicine › Surgery › Pediatric Hepatobiliary Diseases and Treatments
- Keywords
- primary sclerosing cholangitis, TGR5, bile acid receptors, cholangiocytes, ursodeoxycholic acid, ERK1/2 phosphorylation, ICAM-1, VCAM-1, TGF-beta2, biliary fibrosis, cholestatic liver disease
- MeSH terms
- Animals, Biliary Tract, Disease Models, Animal, Epithelial Cells, Liver, Cholangitis, Sclerosing, Down-Regulation, Virulence Factors, Receptors, G-Protein-Coupled, Mice
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