Suppressing the intestinal farnesoid X receptor/sphingomyelin phosphodiesterase 3 axis decreases atherosclerosis

• Published in: The Journal of clinical investigation Vol. 131; no. 9
• Main Authors: Wu, Qing, Sun, Lulu, Hu, Xiaomin, Wang, Xuemei, Xu, Feng, Chen, Bo, Liang, Xianyi, Xia, Jialin, Wang, Pengcheng, Aibara, Daisuke, Zhang, Shaofei, Zeng, Guangyi, Yun, Chuyu, Yan, Yu, Zhu, Yicheng, Bustin, Michael, Zhang, Shuyang, Gonzalez, Frank J., Jiang, Changtao
• Format: Journal Article
• Language: English
• Published: United States American Society for Clinical Investigation 01.05.2021
• Subjects: Animals; Atherosclerosis; Atherosclerosis - chemically induced; Atherosclerosis - drug therapy; Atherosclerosis - genetics; Atherosclerosis - metabolism; Ceramides - biosynthesis; Ceramides - genetics; Complications and side effects; Development and progression; Diet, High-Fat - adverse effects; Female; Health aspects; Humans; Hypercholesterolemia; Intestinal Mucosa - metabolism; Male; Mice; Mice, Knockout, ApoE; Phosphodiesterases; Physiological aspects; Receptors, Cytoplasmic and Nuclear - antagonists & inhibitors; Receptors, Cytoplasmic and Nuclear - genetics; Receptors, Cytoplasmic and Nuclear - metabolism; Risk factors; Sphingomyelin Phosphodiesterase - genetics; Sphingomyelin Phosphodiesterase - metabolism; Ursodeoxycholic Acid - analogs & derivatives; Ursodeoxycholic Acid - pharmacology; China; Cardiovascular disease; Cardiology; Vascular Biology; Atherosclerosis
• ISSN: 1558-8238; 0021-9738; 1558-8238
• DOI: 10.1172/JCI142865

Intestinal farnesoid X receptor (FXR) signaling is involved in the development of obesity, fatty liver disease, and type 2 diabetes. However, the role of intestinal FXR in atherosclerosis and its potential as a target for clinical treatment have not been explored. The serum levels of fibroblast growth factor 19 (FGF19), which is encoded by an FXR target gene, were much higher in patients with hypercholesterolemia than in control subjects and were positively related to circulating ceramide levels, indicating a link between intestinal FXR, ceramide metabolism, and atherosclerosis. Among ApoE-/- mice fed a high-cholesterol diet (HCD), intestinal FXR deficiency (in FxrΔIE ApoE-/- mice) or direct FXR inhibition (via treatment with the FXR antagonist glycoursodeoxycholic acid [GUDCA]) decreased atherosclerosis and reduced the levels of circulating ceramides and cholesterol. Sphingomyelin phosphodiesterase 3 (SMPD3), which is involved in ceramide synthesis in the intestine, was identified as an FXR target gene. SMPD3 overexpression or C16:0 ceramide supplementation eliminated the improvements in atherosclerosis in FxrΔIE ApoE-/- mice. Administration of GUDCA or GW4869, an SMPD3 inhibitor, elicited therapeutic effects on established atherosclerosis in ApoE-/- mice by decreasing circulating ceramide levels. This study identified an intestinal FXR/SMPD3 axis that is a potential target for atherosclerosis therapy.