Cystic fibrosis-associated
liver disease is a chronic cholangiopathy that negatively affects the quality of life of
cystic fibrosis patients. In addition to reducing biliary
chloride and
bicarbonate secretion, up-regulation of
toll-like receptor 4/nuclear factor kappa light-chain-enhancer of activated B cells (NF-κB)-dependent immune mechanisms plays a major role in the pathogenesis of
cystic fibrosis-associated
liver disease and may represent a therapeutic target.
Nuclear receptors are
transcription factors that regulate several intracellular functions. Some
nuclear receptors, including
peroxisome proliferator-activated receptor-γ (
PPAR-γ), may counterregulate
inflammation in a tissue-specific manner. In this study, we explored the anti-inflammatory effect of
PPAR-γ stimulation in vivo in
cystic fibrosis transmembrane conductance regulator (Cftr) knockout mice exposed to
dextran sodium sulfate and in vitro in primary cholangiocytes isolated from wild-type and from Cftr-knockout mice exposed to
lipopolysaccharide. We found that in CFTR-defective biliary epithelium expression of
PPAR-γ is increased but that this does not result in increased receptor activity because the availability of bioactive
ligands is reduced. Exogenous administration of synthetic agonists of
PPAR-γ (
pioglitazone and
rosiglitazone) up-regulates
PPAR-γ-dependent genes, while inhibiting the activation of NF-κB and the secretion of proinflammatory
cytokines (
lipopolysaccharide-induced
CXC chemokine,
monocyte chemotactic protein-1,
macrophage inflammatory protein-2,
granulocyte colony-stimulating factor, keratinocyte
chemoattractant) in response to
lipopolysaccharide.
PPAR-γ agonists modulate NF-κB-dependent
inflammation by up-regulating nuclear factor of kappa light
polypeptide gene enhancer in B cells inhibitor alpha, a negative regulator of NF-κB. Stimulation of
PPAR-γ in vivo (
rosiglitazone) significantly attenuates biliary damage and
inflammation in Cftr-knockout mice exposed to a
dextran sodium sulfate-induced portal
endotoxemia.
CONCLUSION: These studies unravel a novel function of
PPAR-γ in controlling biliary epithelium
inflammation and suggest that impaired activation of
PPAR-γ contributes to the chronic inflammatory state of CFTR-defective cholangiocytes.