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Thyroid hormone receptors regulate adipogenesis and carcinogenesis via cross-talk
signaling with peroxisome proliferator-activated receptors
Changxue Lu and Sheue-yann Cheng
Laboratory of Molecular Biology, Center for Cancer Research, National Cancer Institute,
National Institutes of Health, Bethesda, MD 20892, USA
Running head: Cross-talk of TR with PPAR signaling
‡To whom correspondence should be addressed at: Laboratory of Molecular Biology,
National Cancer Institute, 37 Convent Dr, Room 5128, Bethesda, MD 20892-4264
Tel: (301) 496-4280; Fax: (301) 480-9676; E-mail: [email protected]
Page 1 of 34 Accepted Preprint first posted on 9 September 2009 as Manuscript JME-09-0107
Copyright © 2009 by the Society for Endocrinology.
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Abstract
Peroxisome proliferator-activated receptors (PPARs) and thyroid hormone receptors (TRs) are
members of the nuclear receptor superfamily. They are ligand-dependent transcription factors
that interact with their cognate hormone response elements in the promoters to regulate
respective target gene expression to modulate cellular functions. While the transcription
activity of each is regulated by their respective ligands, recent studies indicate that via
multiple mechanisms PPARs and TRs cross-talk to affect diverse biological functions. Here
we review recent advances in the understanding of the molecular mechanisms and biological
impact of cross-talk between these two important nuclear receptors, focusing on their roles in
adipogenesis and carcinogenesis.
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Introduction
Peroxisome proliferator-activated receptors (PPARs) and thyroid hormone receptors (TRs) are
ligand-dependent transcription receptors of the subfamily 1 (NR1) in the nuclear receptor
superfamily. The NR1 group also includes retinoic acid receptors (RARs), Rev-erb, RAR-
related orphan receptors (RORs), oxysterol receptors (LXRs), vitamin D3 receptors (VDRs),
and the nuclear xenobiotic receptor CAR (constitutive androstane receptor). PPARs and TRs
share a conserved DNA binding domain and exert their activity partly by heterodimerization
with a common partner, the retinoid X receptor (RXR), to regulate the transcription of target
genes. PPARs and TRs each have diverse effects on developmental and metabolic processes
as well as in diseases such as obesity, diabetes, and cancer. The first part of this review
describes current understanding of PPAR and TR biology. The second part highlights recent
advances in the understanding of molecular mechanisms underlying the PPAR-TR cross-talks,
with particular emphasis on the role of such cross-talk in metabolism and carcinogenesis.
1.1 Peroxisome proliferator-activated receptors
PPARs, which consist of PPARα (NR1C1), PPARβ/δ (NR1C2, hereafter referred to as
PPARδ), and PPARγ (NR1C3) (Figure 1), are encoded by three different genes (PPARA,
PPARD, and PPARG) located at chromosomes 22, 6, and 3, respectively. Upon ligand
binding, PPARs are recruited to peroxisome proliferator response elements (PPREs) in the
regulatory region of target genes as heterodimers with the auxiliary factor RXR. With the
PPAR/RXR heterodimers, either partner can bind cognate ligands and elicit ligand-dependent
transactivation (Kliewer, et al. 1992). The canonical PPRE contains two direct repeats of the
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hormone response element (HRE) half site (AGGTCA) with a one base-pair spacer in
between (DR1) (Kliewer et al. 1992; Tugwood, et al. 1992).
Natural and synthetic ligands have been reported for the three PPAR isotypes
(Balakumar, et al. 2007; Bensinger and Tontonoz 2008) (Table 1 & Figure 2). For PPARα,
ligands include natural unsaturated fatty acids (FAs), leukotriene, HETEs
(hydroxyeicosatetraenoic acids), and synthetic hypolipemia-inducing such as fibrates. The
PPARδ ligands are less well known, but FAs have been suggested to be natural ligands for
this subtype of PPAR (Fyffe, et al. 2006). Recent studies identified a few more PPARδ
agonists, namely tetradecylthioacetic acid (TTA), L-165041, and GW501516 (Berger, et al.
1999; Oliver, et al. 2001; Westergaard, et al. 2001). For PPARγ, endogenous ligands include
polyunsaturated FAs, prostanoids, and oxidized FAs found in low-density lipoproteins (LDLs)
(Davies, et al. 2001; Forman, et al. 1995; Kliewer, et al. 1995). Synthetic ligands for PPARγ
include antidiabetic drugs, such as rosiglitazone and pioglitazone of the thiazolidinedione
(TZD) class. This wide variety of ligands for PPARs requires a flexible plasticity in the PPAR
ligand-binding domain (LBD), which is suggested by the PPARγ crystallized structure (Nolte,
et al. 1998).
PPARα is predominantly expressed in tissues with high turnover rates of FA
metabolism, such as liver, brown adipose tissue (BAT), heart, and kidney. The target genes of
PPARα are mainly involved in mitochondrial and peroxisomal β-oxidation of FAs and
apolipoprotein synthesis. PPARδ is ubiquitously expressed in tissues. Its target genes are
involved in FA oxidation, fuel switch, mitochondrial respiration, and thermogenesis (Barish,
et al. 2006; Furnsinn, et al. 2007). PPARγ expression is mainly found in BAT and white
adipose tissue (WAT) and, to a lesser extent, in the large intestine, retina, and some immune
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cells (e.g., macrophage and T lymphocyte) (Harris and Phipps 2001; Ricote, et al. 1998).
Activation of PPARγ affects glucose metabolism and insulin sensitization. That PPARγ also
has a dominant role in adipogenesis is suggested by many loss-of-function studies both in vivo
and in vitro (Fajas, et al. 2001).
1.2 Thyroid hormone receptors
In humans, TRs are encoded by two genes, THRA and THRB, located at chromosomes 17 and
3, respectively. The THRA gene encodes three TRα (NR1A1) isoforms, TRα1, TRα2, and
TRα3, which differ in their carboxyl terminus as a result of alternative splicing of the primary
transcripts (Figure 1). TRα1 binds T3 and activates or represses target genes, whereas TRα2
and TRα3 do not bind T3 and may antagonize T3 action (Izumo and Mahdavi 1988; Macchia,
et al. 2001; Mitsuhashi, et al. 1988). The THRA gene also yields two truncated proteins known
as TR∆α1 and TR∆α2, which play a role in intestinal development (Chassande, et al. 1997;
Plateroti, et al. 2001). The THRB gene encodes two amino-terminal TRβ (NR1A2) protein
variants—TRβ1 and TRβ2. In rodents, the same gene also gives rise to TRβ3 and a truncated
protein TR∆β3, which lacks the DNA-binding domain (DBD) (Harvey, et al. 2007; Williams
2000).
TRs bind to thyroid hormone response elements (TREs) in target genes as homodimers
as well as heterodimers with RXR. Most naturally occurring positive TREs identified to date
include 2 repeats of the half site 5’-AGGTCA-3’, which is also shared by PPREs arranged as
a direct repeat with 4 base pairs between the two half sites (DR4). Among known TREs,
inverted repeats (also called palindromes) (e.g., GGTCATGACCTA) and everted repeats
(e.g., GACCT(N6)AGGTCA, N: any nucleotide) have also been reported (Brent, et al. 1989;
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Farsetti, et al. 1992; Forman, et al. 1992; Glass, et al. 1988). TRs have also been shown to
heterodimerize with other nuclear receptors, such as PPARs and VDRs (Bogazzi, et al. 1994;
Schrader, et al. 1994). In the presence of PPARα, TRβ has binding affinity to a DR2 present
in the myelin proteolipid protein gene promoter but not to the classical TRE, DR4, located in
the malic enzyme gene. Upon thyroid hormone stimulation, the DR2-driven reporter gene is
activated by the TRβ-PPARα heterodimer but not by TRα-PPARα, TRα-RXRβ or TRβ-
RXRβ. Three amino acids in the D box of the DBD in TRβ are critical for this
heterodimerization. The dissimilarity of the D boxes between TRβ and TRα may be
responsible for this isoform-dependent protein interaction and the DNA binding sequence
specificity (Bogazzi et al. 1994). In humans, the DBDs of TRs and PPARs are highly
homologous. Importantly, TRs and PPARs share the same proximal box (P-box) sequence in
DBD, which is critical in sequence-specific recognition of HRE by NRs while providing
contact surface with the major groove of double-stranded DNA (Nelson, et al. 1995;
Rastinejad, et al. 1995).
Triiodothyronine (T3) is the most active form of thyroid hormone in target tissues
whereas L-thyroxine (T4) is the most abundant thyroid hormone in the blood. Deiodination of
T4 by either type I or type II 5’-deiodinase (DI or DII) in different tissues gives rise to the
more active T3 locally. Several synthetic agonists for TRs have also been developed in the
past decade (Table 1). Among them, GC-1 and KB-141 have been extensively studied and
show a higher affinity to the TRβ subtype. In animal models, these TRβ-specific agonists
decrease plasma cholesterol and triglyceride levels and induce fat loss
without apparent
adverse effects on the heart and muscles (Baxter, et al. 2004; Grover, et al. 2003).
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Similar to PPARs, tissue-dependent distribution of TR isoforms regulates thyroid
hormone actions in target organs. Both TRα and TRβ are expressed in virtually all tissues but
the abundance varies for each isoform (Lazar 1993). TRα1 is abundantly expressed in the
skeletal muscle, heart, and brown adipose tissue whereas TRα2 mRNA is highly expressed in
the brain. TRβ1 is more expressed in the brain, liver, and kidney. TRβ2 has a more restricted
expression pattern, with major distribution in the anterior pituitary and hypothalamus (Hodin,
et al. 1989). The isoform-dependent distribution further adds to the complexity in the
regulation of T3 actions.
2. Cross-talk of PPARs and TRs in metabolism and adipogenesis
2.1 Reciprocal regulation between TRs and PPARs
As do PPARs, TRs also play important roles in lipid mobilization, lipid degradation, FA
oxidation, and glucose metabolism. By direct or indirect effect, thyroid status influences the
expression of a number of genes involved in lipid and glucose metabolism. For example, TR
isoform-specific regulation of hepatic genes involved in lipogenesis and FA oxidation has
been implicated by the cDNA array analysis of TRβ knockout mice treated
with or without
thyroid hormone (Flores-Morales, et al. 2002). Among more than 200 hepatic genes
responding to T3 treatment, approximately 60% of them are regulated by TRβ
and the
remaining 40% are regulated through TRα. PPARα is one of the T3-regulated genes (Flores-
Morales et al. 2002).
In vivo studies reveal that TR and PPAR signaling can similarly regulate some
pathways in the lipid and glucose metabolism. In corticosteroid-induced diabetic mice, a
decreased thyroid hormone level is accompanied by increased serum levels of insulin, total
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cholesterol, triglycerides, and tissue lipid peroxidation. Interestingly, the PPARγ-agonist
rosiglitazone is able to reverse the effect of dexamethasone and to increase T3 and T4 levels
in circulation (Jatwa, et al. 2007). Moreover, in rats with a high-fat diet and in a hyperthyroid
state, administration of the PPARα agonist Wy14,643 restores glucose tolerance by enhancing
glucose-stimulated insulin secretion and relieves the effect of hyperthyroidism. These studies
suggest that activation of PPARα activity may restore the islet function affected by abnormal
T3-TR signaling (Holness, et al. 2008).
Cross-talk between TR and PPAR signaling pathways has also been implicated in the
gene expression patterns in rats fed a high-fat diet. This diet induces an expression of the
PPARα gene with a concomitant decrease in expression in the liver of RARβ, TRα1, and
TRβ1. In WAT, this diet increases the expression of PPARγ2 but reduces expression of
RARα, TRα1, and TRβ1 (Redonnet, et al. 2001). Similar results have been obtained by using
a specific PPARα inducer, bezafibrate, in rats. After a 10-day treatment with bezafibrate,
PPARα transcription is elevated with an activation of the downstream gene, acyl-CoA oxidase
(AOX), and a decrease of maximal ligand binding capacity of RARβ and TRα1/β1(Bonilla, et
al. 2001). However, no RXRα mRNA expression is altered by the treatment (Bonilla et al.
2001; Redonnet et al. 2001).
PPARs have been shown to affect the thyroid hormone functions in thermogenesis in
vivo. Administration of the PPARγ agonist rosiglitazone to male rats shifts the energy usage to
an anabolic state. Moreover, the activation of PPARγ by rosiglitazone markedly reduces
plasma thyroid hormones and mRNA levels of DI and DII in the liver and BAT, respectively.
Rosiglitazone also decreases mRNA levels of the TRα1 and TRβ in BAT and the TRα1 and
TRα2 in retroperitoneal WAT. These results explain the functions of PPARγ in up-regulating
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thermogenesis-related genes in WAT and BAT while balancing the whole body
thermogenesis by down-regulating the transcription activity of TRs in these processes
(Festuccia, et al. 2008). Regulation of DII by PPARγ activation has also been identified in
skeletal muscle in which the expression of DII was found to be induced by PPARγ agonists,
e.g., pioglitazone. Thus, via regulation of DII expression, PPARγ provides an additional level
of regulation via modulation of thyroid hormone metabolism (Grozovsky, et al. 2009).
Studies of energy metabolism in rats show that the PPARδ expression is modulated by
T3-TR signaling. By elevating the T3 level in hypothyroid rats, the expression of
mitochondrial PPARδ in skeletal muscle is induced along with the increased mRNA level of
mitochondria protein uncoupling protein 3 (UCP3) (de Lange, et al. 2007). More recently, in a
study using transgenic mice overexpressing the putative mitochondrial T3 receptor p43 (an
A/B domain truncated form of TRα1 (Casas, et al. 1999; Wrutniak-Cabello, et al. 2001)) in
skeletal muscles, an increased protein level of PPARδ was observed (Casas, et al. 2008).
Taken together, these findings provide evidence that TR and PPAR can cross-talk by
reciprocally affecting each other’s activity.
2.2 Competition for the auxiliary factor RXR by PPAR and TR
It is reasonable to postulate that TRs and PPARs can regulate some common target genes
involved in metabolic functions. As previously mentioned, transcriptional activities of PPARs
and TRs are determined by several factors including hormone availability, relative distribution
of receptor isoforms, and the abundance of the auxiliary factor, the RXR and other
coregulators. On the bases of the sequence homology of hormone response elements (HREs)
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and the sharing of the heterodimerization partner RXR, several mechanisms have been
proposed to understand the cross-signaling between PPARs and TRs.
An early study examined the effect of PPARδ on the binding of TRβ to TREs and
transcription activity (Meier-Heusler, et al. 1995). Via eletrophoretic mobility shift assay
(EMSA), PPARδ was shown to reduce the binding of TRβ-RXRα to TRE, but PPARδ itself
had no affinity to the TRE either as a homodimer or heterodimer with RXRα. In a
chloramphenicol-acetyl-transferase (CAT) activity assay, however, PPARδ exerted an
inhibitory effect on T3-induced transcription activation by TRβ on the TRE-CAT reporter
gene even in the presence of overexpressed RXRα protein in cells. These results suggest that
PPARδ inhibits the transcriptional activity of TR action by competing for the heterodimerized
partner RXR in the nucleus (Meier-Heusler et al. 1995).
In another report, by site-mutagenesis, a single leucine replacement by arginine at
position 433 (L433R) of PPARα was shown to be critical in the inhibition of TR action. This
L443R alteration abolishes heterodimerization of PPARα with RXR and consequently its
selective inhibitory effect on the TR action. A mutational study also supports the idea that
PPARα does not compete with TRs for binding of TREs. Mutation in the P-box of hPPARα
(C122S), which destroys the DNA binding ability of PPARα, does not affect its interference
with TR transactivation. These findings suggest that PPARα inhibits TRα transactivation by
competing with TRα for binding to the auxiliary factor RXR (Juge-Aubry, et al. 1995).
In a similar manner as PPARs, TRs also inhibit the activity of several peroxisomal FA
oxidation enzymes regulated by both of these nuclear receptors. In transgenic mice expressing
luciferase under the control of promoter of the rat peroxisomal enoyl-CoA hydratase/3-
hydroxyacyl-CoA dehydrogenase, T3 inhibits ciprofibrate-induced luciferase activity in a TR-
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ependent fashion. EMSA analyses reveal that regulation of the PPAR action by TR is through
competition for the available RXR. Increasing the amount of RXR in cells partially reverses
the TR inhibition on PPAR action while heterodimerization-defective TR mutants lose the
inhibitory activity. These results suggest that the peroxisome proliferators- and T3-signaling
pathways converge through their common interaction with the heterodimeric partner RXR
(Chu, et al. 1995).
2.3 Competition for HRE binding by PPARs and TRs
In addition to competition for binding to the common heterodimeric partner (i.e., RXR),
TRs compete with PPARs for binding to HREs on certain target genes. EMSA analysis shows
that TRα binds to rat AOX PPRE, thus inhibiting the binding of PPAR to PPRE as
PPAR/RXRα heterodimers. However, as shown by transient transfection assays, TRα
stimulates transactivation by PPAR/RXRα heterodimers on the AOX-PPRE-luciferase
reporter gene in a T3-independent manner with unknown mechanism (Hunter, et al. 1996).
Moreover, comparison of reporter activity between wild type and DBD-mutated (C78S) TRα1
shows that TRα1 exerts a DBD-dependent, inhibitory effect on the PPAR-induced AOX gene
transcription (Miyamoto, et al. 1997).
An in vivo study using mouse models also implicates an interdependent relationship
between TRs and PPARs via competition for binding to HREs. Via affecting the mRNA
expression levels of many genes including carnitine palmitoyl-transferase Iα (CPT-Iα), AOX,
acyl-CoA dehydrogenase (ACD), male mutant mice harboring a dominant-negative P398H
mutated TRα1 manifest visceral obesity, hyperleptinemia, reduced catecholamine-stimulated
lipolysis in WAT, and hepatic steatosis (Liu, et al. 2007). In the absence of T3, wild-type
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TRα1 and P398H mutant significantly reduce PPARα-mediated gene transcription in CPT-
PPRE-luciferase assay. However, thyroid hormone reverses the inhibition of PPARα action by
wild-type TRα but not by the P398H mutant. In vitro studies suggest that the P398H mutant
itself is able to bind PPRE and reduce PPARα binding to PPREs. It is not clear whether
P398H mutant competes with PPARα for binding to RXR. The metabolic phenotype exhibited
by P398H mutant mice is mediated in part via the unique properties of the P398H mutant
receptor in interfering with PPARα signaling (Liu et al. 2007).
2.4 TR isoform-specific regulation of PPAR signaling in lipid metabolism
The role of TR isoforms in lipid metabolism has been recently studied in vivo using a loss-of-
function approach. Mice expressing an identical mutation (denoted as PV) in the
corresponding C-terminal region of TRα1 (TRα1PV
mouse; (Kaneshige, et al. 2001)) or TRβ1
were created (TRβPV
mouse; (Kaneshige, et al. 2000)). The PV mutation was identified in a
patient with resistance to thyroid hormone (RTH) who has a frameshift mutation in the C-
terminal 14 amino acids of TRβ, resulting in a complete loss of T3 binding and transcriptional
capacity. This PV mutation exhibits potent dominant-negative activity. Compared with
TRα1PV
mice, TRβPV
mice exhibit no reduction in white adipose mass but have significant
increases in serum free FAs and total triglycerides (Ying, et al. 2007). The impaired
adipogenesis in the white adipose tissue is mediated by the repression of the expression of
PPARγ by TRα1PV, leading to the reduced expression of genes involved in lipid synthesis
(Ying et al. 2007). Thus, in the white adipose tissue, cross-talk with PPARγ signaling is TR
isoform-dependent.
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The TR isoform-dependent cross-talk with PPARγ is not limited to the white adipose
tissue. Liver steatosis was observed in TRβPV
mice while a reduced liver mass with scarcity
of lipid drops was detected in TRα1PV
mice (Araki, et al. 2009). In the liver of TRβPV
mice,
TRβPV activates PPARγ signaling with increased expression of PPARγ and downstream
lipogenic genes. With the increased expression of the lipogenesis together with TRβPV-
mediated decreased FA β-oxidation activity, excess lipid accumulation is observed in the liver
of TRβPV
mice. In contrast, TRα1PV functions to decrease the expression of PPARγ and its
downstream lipogenic genes, leading to reduced fat mass in the liver of TRα1PV
mice (Araki
et al. 2009). These results indicate that PPARγ signaling in the liver is distinctively regulated
by TR isoforms (Araki et al. 2009). Thus, these in vivo findings highlight the differential
regulation by TR isoforms of the PPARγ signaling in lipid metabolism.
At present, the detailed molecular mechanisms by which TR isoforms mediate
differential cross-talk with PPARγ signaling in the liver and white adipose tissue are not
known. It is possible that similar to the earlier report by Bogazzi (Bogazzi, et al. 1994),
PPARγ could have selectivity in the heterodimerization with TRα or TRβ, resulting in
differential functional consequences in lipid metabolism of these two target tissues.
Alternatively, the different co-regulatory proteins in these two target tissues could play
differential modulatory roles, leading to differential regulation in lipid metabolic pathways. In
view of the importance of the cross-talk of PPARγ with TRs in the regulation of lipid
metabolism, these issues would merit additional studies in the future.
3. Cross-talk signaling of PPARs and TRs in cancers
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3.1 PPARs in cancers
PPARs have been implicated in several cancers including colon cancer, thyroid cancer,
and pancreatic carcinoma. However, their roles in the tumorigenesis of these cancers are
controversial. Recent studies suggest that PPARδ has a role in promoting colon tumorigenesis.
Mice with PPARδ gene disruption in colonic epithelial cells have a decreased incidence of
chemical carcinogen azoxymethane-induced colon tumors (Zuo, et al. 2009). Loss of PPARδ
also suppresses the elevated expression of vascular endothelial growth factor in tumor tissue
(Zuo et al. 2009). By contrast, in PPARδ-/-
ApcMin/+
(APC: adenomatosis polyposis coli gene;
Min: multiple intestinal neoplasia) mice, colon polyp formation is significantly greater than in
ApcMin/+
mice, suggesting that PPARδ attenuates colon carcinogenesis and therefore can
function as a tumor suppressor (Harman, et al. 2004).
PPARγ has also been proposed as a tumor suppressor in colon carcinogenesis. In
primary colorectal adenocarcinomas, approximately 8% of patients contain a loss-of-function
mutation in one PPARγ allele (Sarraf, et al. 1999). PPARγ agonists can decrease premalignant
intestinal lesions in rats treated with azoxymethane (Tanaka, et al. 2001). When PPARγ is
activated in primary colon tumors and colon cancer cell lines by PPARγ agonists, these cells
appear to stop proliferation with reduced growth and altered morphology of increased
differentiation (Sarraf, et al. 1998). Moreover, in Pparg+/-
mice with azoxymethane treatment,
a greater incidence of colon cancer with an increase of β-catenin level is observed as
compared with wild-type mice (Girnun, et al. 2002). However, an oncogenic role of PPARγ in
colon cancer has also been suggested in several reports. For example, activating of PPARγ
signaling by treating ApcMin
mice with the PPARγ ligand troglitazone increases significantly
the number of colon polyps as compared with the untreated mice (Saez, et al. 1998).
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Human pancreatic carcinoma cells express functional PPARγ that upon activation by
its ligand, troglitazone, induces growth inhibition associated with G1 cell cycle arrest
(Motomura, et al. 2000). It has been further shown that p27Kip1
can also play a key role in
mediating the inhibitory effect by troglitazone (Motomura et al. 2000). A similar effect is also
observed in human pancreatic cancer cell lines by using PPARγ ligands, 15-deoxy-∆12,14
-
prostaglandin J2 (15d-PGJ2), and ciglitazaone. That approach showed 15d-PGJ2 induces
apoptosis through activation of caspases and reduces cell invasiveness by decreasing MMP-2
and MMP-9 protein levels and activity (Hashimoto, et al. 2002). These findings raise the
possibility that PPARγ as a potential therapeutic target for treatment of human pancreatic
carcinomas.
The role of PPARγ in thyroid cancer was discovered by the identification of the fusion
gene, the paired box 8 (PAX8)-peroxisome proliferator-activated receptor-γ (PPARγ, PAX8-
PPARγ) (Kroll, et al. 2000). Chromosomal t(2;3)(q13;p25) rearrangement results in the fusion
of the thyroid transcription factor PAX8 gene to the PPARγ gene and the expression of a
dominant negative form of PPARγ1 protein (PAX8-PPARγ fusion protein, PPFP). PAX8-
PPARγ rearrangement occurs in 25-70% of follicular thyroid cancers (FTC) (Kroll et al.
2000). Immortalized human thyrocytes or thyroid cancer cell lines expressing the PPFP have
increased cell viability and growth (Espadinha, et al. 2007; Gregory Powell, et al. 2004).
Array analysis shows that the expression of PPFP in cells leads to gene expression profiles
with distinct transcriptional signature. PPFP acts to up-regulation of genes associated with
signal transduction, cell growth, and translational control. Concurrently, PPFP represses a
large number of ribosomal protein and translational associated genes (Giordano, et al. 2006;
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Lacroix, et al. 2005; Lui, et al. 2005). However, it is poorly understood how the fusion protein
causes FTC.
More recently, a second PPARγ gene rearrangement, CREB3L2-PPARγ, was reported
in a patient with FTC. This fusion gene encodes a CREB3L2-PPARγ fusion protein that
consists of the transactivation domain of CREB3L2 and functional domains of PPARγ1.
CREB3L2-PPARγ occurs infrequently in FTC (<3% of FTC). This fusion protein induces
proliferation in primary thyroid cells, but has lost the responsiveness to the PPARγ agonists—
troglitazone and rosiglitazone (Lui, et al. 2008).
PPARδ has also been implicated in thyroid carcinogenesis. In vivo, a higher expression
level of PPARδ is associated with increased proliferation in human thyroid tumors. This
increased PPARδ can be induced by thyroid mitogen (e.g., TSH and insulin) in normal
primary thyrocytes that are cyclin E1-dependent (Zeng, et al. 2008).
3.2 TRs in cancers
T3-TR signaling has also been implicated in the tumorigenesis of the liver, breast, thyroid,
and colon. A variety of tumor cells respond to the stimulation of thyroid hormone to
proliferate in vitro or in vivo (Esquenet, et al. 1995; Iishi, et al. 1993; Short, et al. 1980; Zhou-
Li, et al. 1992). For example, thyroid hormone enhances liver cancer cell invasion by inducing
the expression of furin protein, a pro-protein convertase involved in tumor cell metastasis. The
FURIN gene contains putative TREs and Smad binding sites. Under stimulation by thyroid
hormone or the transforming growth factor β (TGFβ), FURIN expression is induced and the
increased protein level subsequently cleaves and activates matrix metalloproteinases such as
MMP2 and MMP9 to increase tumor cell mobility (Chen, et al. 2008). In xenograft models,
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the number of metastatic foci in liver and lung is increased with overexpression of furin in
HepG2 cells. In addition, an increased T3 level in the hypothyroid severe combined
immunodeficiency (SCID) mice injected with HepG2 overexpressing TRα1 (HepG2-TRα1)
cells also leads to an increased number of metastatic foci in liver and lung (Chen et al. 2008).
An anti-tumorigenic effect of thyroid hormone has also been reported for several tumor
cell types (Ledda-Columbano, et al. 1999; Martinez-Iglesias, et al. 2009). T3 suppresses the
growth and invasiveness of several human papillary thyroid cancer cell lines overexpressing
wild-type TRβ1 by inhibition of Akt and MAPK signaling pathways (Sedliarou, et al. 2007).
The suppression by TRβ1 of growth and invasiveness has been similarly observed in
hepatocarcinoma and breast cancer cells. In responding to growth factors including epidermal
growth factor, insulin-like growth factor-I, and TGFβ, the growth of hepatic and breast tumor
cells is increased via activation of the MAPK and PI3K signaling pathways. However, an
expression of TRβ1 blocks the growth response of these tumor cells by suppressing the
MAPK and PI3K signaling pathways (Martinez-Iglesias et al. 2009).
The clinical evidence from a case-control study shows that hypothyroidism increases the
risk of hepatocellular carcinoma by two- to three-fold (Hassan, et al. 2009). Furthermore,
decreased expression of TRβ1 is also found in patients with colorectal adenoma and
adenocarcinoma. Compared with normal colon epithelium, nuclear TRβ1 is less frequently
detected in colorectal cancer and its precursor abnormalities (such as adenomas) (Horkko, et
al. 2006). The reduced levels of TRβ1 are also associated with the polypoid growth, presence
of K-ras mutations, and more advanced stages of colorectal cancers (Horkko et al. 2006). In
APC gene-deficient mice, Wnt/β-catenin signaling is activated with increased cyclin D1
expression (Hulit, et al. 2004). Interestingly, in a colon carcinoma cell line SW480 with
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genetic mutation in the APC gene, the high transcriptional activity of cyclin D1 promoter
induced by β-catinin signaling is inhibited by overexpressing TRβ1 with the presence of T3
[77]. These studies provide evidence that T3-TR signaling play key roles in carcinogenesis.
3.3. Cross-talk signaling by PPARs and TRs in carcinogenesis
Studies described in the previous sections [see Section 2.1] provide evidence that PPARs and
TRs can reciprocally inhibit transcriptional activity of the genes involved in metabolic
regulation either by competing for binding to the HREs or to RXR. These mechanisms can
also be extended to describe the molecular basis underlying the cross-talk signaling by PPARs
and TRs in the regulation of genes involved in carcinogenesis.
Compelling evidence to indicate that PPARγ and TRβ cross-talk affects thyroid
carcinogenesis is revealed in an animal model of FTC (TRβPV/PV mice) (Suzuki, et al. 2002).
As described in Section 2.4, the TRβPV knockin mouse was initially created to model an
inheritable disease called RTH (Kaneshige et al. 2000). And indeed, TRβPV mice faithfully
recapitulate human RTH (Kaneshige et al. 2000).
Remarkably, as homozygous TRβPV (TRβPV/PV
) mice age, they spontaneously develop
FTC with a pathological progression similar to human FTC (Suzuki et al. 2002). Consistent
with the findings in human thyroid cancer (See Section 3.1), a down-regulation of the PPARγ
gene in thyroid tumors of TRβPV/PV mice is made evident by decreased mRNA and protein
levels. In vitro and in vivo findings indicate that the mutated TRβPV protein acts to inhibit the
ligand-dependent transcription of PPARγ by competitive binding to PPREs (Araki, et al.
2005; Ying, et al. 2003). Cell-based transfection studies using PPRE-containing reporters
indicate that TRβ1 acts to enhance the transcription activity of PPARγ in the presence of both
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T3 and troglitazone. TRβPV also binds to PPRE as TRβ1 does, but due to its lack of T3
binding, TRβPV acts to interfere with the enhancing effect of TRβ1 on the transcription of
PPARγ (Ying et al. 2003). Treating TRβPV/PV mice with a PPARγ agonist, rosiglitazone,
delays tumor progression and blocks metastatic spread (Kato, et al. 2006). Moreover, when
one allele of the PPARγ gene is disrupted in TRβPV mice, progression of FTC is accelerated
(Kato et al. 2006). These data suggest that the mutated TRβPV is a dominant negative
regulator of PPARγ action. Two other PPARγ agonists, ciglitazone and 15d-PGJ2, have also
been shown to decrease viability of a thyroid cancer cell line, CGRH W-2 (Chen, et al. 2006).
These two PPARγ agonists induce apoptosis of thyroid cancer cells through the caspase 3 and
PTEN-Akt signaling cascade, and they induce necrosis via the poly (ADP-ribose) polymerase
(PARP) pathway (Chen et al. 2006).
4. Conclusions and Future Perspectives
Recent studies have indicated that PPARs and TRs can cross-talk to affect diverse cellular
functions. Evidence presented in this review reveals three possible molecular mechanisms that
may account for the cross-talk at the gene regulation level (Figure 3). Several lines of
evidence support the notion that there is direct competition between PPARs and TRs for
HRE-binding and/or partnership with RXR. Moreover, the differential binding of PPARs or
TRs on DNA may also be determined by the context of the promoter/enhancer of the target
gene. The effect of PPARs and TRs may be cooperative or opposing during the cross-talk, but
most findings suggest the latter. Cross-talk between PPARs and TRs may also be mediated
indirectly, such as a reciprocal regulation of PPAR expression by TRs or vice versa. The TR
Page 19 of 34
20
action may also be regulated indirectly by PPARs, e.g., via its modulating the intermediate
enzyme genes, such as DII involved in T3 metabolism.
Recent exciting developments in the regulation of lipid metabolism and carcinogenesis
by PPARs and TRs prompted us to focus in the present review on advances in understanding
the cross-talk between PPARs and TRs. However, both PPARs and TRs have other important
cellular functions that may also converage as a result of cross-talk between these two
receptors. It is of great interest to identify other biological processes and the target genes
involved that are modulated by this mode of regulation. Furthermore, while the present
review focuses on the cross-talk of these two receptors via nucleus-initiated genomic actions,
the cross-talk may also be via nongenomic actions. The nongenomic actions of these two
receptors have recently been reported (Bergh, et al. 2005; Furuya, et al. 2007; Gardner, et al.
2005). Thus the cross-talk of PPARs and TRs could also be mediated via the nongenomic
actions. In view of these considerations, a rapid development in the understanding in the
biological processes governed by the cross-talks of these two receptors would be forthcoming.
ACKNOWLEDGMENTS
We regret any reference omissions due to length limitation. We wish to thank all colleagues
and collaborators who have contributed to the work described in this review. The present
research was supported by the Intramural Research Program of the Center for Cancer
Research, National Cancer Institute, National Institutes of Health.
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Table 1. Ligands for PPARs and TRs
Receptors Endogenous ligands Synthetic ligands
PPARα Polyunsaturated FAs,
leukotriene B4 (LTB4),
*HETE (Kliewer, et al. 1997)
Clofibrate, fenofibrate,
bezafibrate, gemfibrozil,
ciprofibrate, Wy14,643
(Willson, et al. 2000), BMS-
687453, BMS-711939
(Mukherjee, et al. 2008)
PPARβ/δ Unsaturated or saturated
long-chain Fas, prostacyclin,
eicosanoids, *HODE
(oxidized FA) (Shureiqi, et
al. 2003)
TTA, L-165,041, GW501516
PPARγ HODE (Schopfer, et al.
2005), 15d-PGJ2 (Forman et
al. 1995; Kliewer et al. 1995),
*azPC (Davies et al. 2001),
*LNO2 (unsaturated FA)
(Schopfer et al. 2005)
Rosiglitazone, pioglitazone,
rivoglitazone, troglitazone,
giglitazone, farglitazar,
GW7845 (Willson et al.
2000)
TRα1 T4, T3 CO23 (Ocasio and Scanlan
2006)
TRβ T4, T3 GC-1, KB-141, KB2115,
MB07811 (Baxter and Webb
2009)
* HETE: hydroxyeicosatetraenoic acid; HODE: hydroxyoctadecadienoic acid; azPC:
hexadecyl azelaoyl phosphatidylcholine; LNO2, itrolinoleic acid
Page 21 of 34
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Legends:
Figure 1 Schematic representation of the structures of PPARs and TRs. A. Modular domain
structures of nuclear receptors in general. Two most conserved domains, DBD (C domain)
and LBD (E/F domain) are colored in gray and black, respectively. B. The human PPAR
homologues. Compared with the DBD of PPARα (NR1C1), sequence homology is 86% and
83% in PPARβ/δ (NR1C2) and PPARγ1/2 (NR1C3), respectively. In LBD, sequences are less
conserved with only 70% and 68% of homology for PPARβ/δ and PPARγ1/2, respectively,
using the sequence of PPARα as a reference. C. & D. Structural comparison of rat TRα
isoforms (C) and rat TRβ isoforms (D). The areas of identical shading indicate conserved
sequences among the isoforms. The three major TRα isoforms (TRα1, α/2, and α3) mainly
differ in LBD at the carboxyl-terminus; TRβ isoforms (TRβ1, β2, and β3) mainly differ in
amino terminal A/B domain.
Figure 2 Ligand structures of TRs and PPARs. Chemical structures of several representative
TR or PPAR ligands listed in Table 1 are shown.
Figure 3 Proposed molecular mechanisms in PPAR-TR cross-talk. Three major mechanisms
underlying the cross-talk of PPARs and TRs in target gene regulation are illustrated. A.
Reciprocal regulation of the PPAR and TR expression. The liganded PPAR or TR can
reciprocally affect the gene expression of the other via direct and/or indirect regulation. B.
Competition for HRE binding. TRs competitively bind to PPRE of PPAR target genes. RA:
retinoic acid. C. Competition for RXR partnership. Either TRs (i) or PPARs (ii) compete with
the other receptor for binding to RXR, resulting in decreased availability of RXR to reduce
Page 22 of 34
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the transcriptional activity of PPAR target genes shown in (i) or the transcriptional activity of
PPAR target genes shown in (ii).
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