The farnesoid X receptor (FXR) is a bile acid (BA)-activated nuclear receptor that plays a major role in the regulation of BA and lipid metabolism. Recently, several studies have suggested a potential role of FXR in the control of hepatic carbohydrate metabolism, but its contribution to the maintenance of peripheral glucose homeostasis remains to be established. FXR-deficient mice display decreased adipose tissue mass, lower serum leptin concentrations, and elevated plasma free fatty acid levels. Glucose and insulin tolerance tests revealed that FXR deficiency is associated with impaired glucose tolerance and insulin resistance. Moreover, whole-body glucose disposal during a hyperinsulinemic euglycemic clamp is decreased in FXR-deficient mice. In parallel, FXR deficiency alters distal insulin signaling, as reflected by decreased insulin-dependent Akt phosphorylation in both white adipose tissue and skeletal muscle. Whereas FXR is not expressed in skeletal muscle, it was detected at a low level in white adipose tissue in vivo and induced during adipocyte differentiation in vitro. Moreover, mouse embryonic fibroblasts derived from FXR-deficient mice displayed impaired adipocyte differentiation, identifying a direct role for FXR in adipocyte function. Treatment of differentiated 3T3-L1 adipocytes with the FXR-specific synthetic agonist GW4064 enhanced insulin signaling and insulin-stimulated glucose uptake. Finally, treatment with GW4064 improved insulin resistance in genetically obese ob/ob mice in vivo. Although the underlying molecular mechanisms remain to be unraveled, these results clearly identify a novel role of FXR in the regulation of peripheral insulin sensitivity and adipocyte function. This unexpected function of FXR opens new perspectives for the treatment of type 2 diabetes.The farnesoid X receptor (FXR) 4 (NR1H4) is a nuclear receptor that is activated by bile acids (BAs) (1). A major physiological role of FXR is to protect liver cells from the deleterious effect of BA overload by decreasing their endogenous production and by accelerating BA biotransformation and excretion (1). In addition, the generation and characterization of FXR-deficient (FXR Ϫ/Ϫ ) mice has also established a critical role of FXR in lipid metabolism, since these mice display elevated serum levels of triglycerides and high density lipoprotein cholesterol (2). Recently, several studies have suggested that FXR might also regulate hepatic carbohydrate metabolism (3). The first indication came from the observation that hepatic FXR expression is reduced in several rodent models of diabetes (4). FXR expression also varies in mouse liver during nutritional changes, being increased during fasting and decreased upon refeeding (5, 6). Moreover, FXR activation by BAs or the synthetic nonsteroidal specific agonist GW4064 (7) modulates the expression of the gluconeogenic enzyme phosphoenolpyruvate carboxykinase (3). However, conflicting data report either a positive (8) or a negative effect (9, 10) of BA and/or GW4064 on phosphoenolpyruvate...

Bile acids (BA) are signalling molecules which activate the transmembrane receptor TGR5 and the nuclear receptor FXR. BA sequestrants (BAS) complex BA in the intestinal lumen and decrease intestinal FXR activity. The BAS-BA complex also induces Glucagon-Like Peptide-1 (GLP-1) production by L-cells which potentiates β-cell glucose-induced insulin secretion. Whether FXR is expressed in L-cells and controls GLP-1 production is unknown. Here we show that FXR activation in L-cells decreases proglucagon expression by interfering with the glucose-responsive factor Carbohydrate-Responsive Element Binding Protein (ChREBP) and GLP-1 secretion by inhibiting glycolysis. In vivo, FXR-deficiency increases GLP-1 gene expression and secretion in response to glucose hence improving glucose metabolism. Moreover, treatment of ob/ob mice with the BAS colesevelam increases intestinal proglucagon gene expression and improves glycemia in a FXR-dependent manner. These findings identify the FXR/GLP-1 pathway as a new mechanism of BA control of glucose metabolism and a pharmacological target for type 2 diabetes.

The liver X receptors (LXRs) are nuclear receptors that form permissive heterodimers with retinoid X receptor (RXR) and are important regulators of lipid metabolism in the liver. We have recently shown that RXR agonist-induced hypertriglyceridemia and hepatic steatosis in mice are dependent on LXRs and correlate with an LXR-dependent hepatic induction of lipogenic genes. To further investigate the roles of RXR and LXR in the regulation of hepatic gene expression, we have mapped the ligandregulated genome-wide binding of these factors in mouse liver. We find that the RXR agonist bexarotene primarily increases the genomic binding of RXR, whereas the LXR agonist T0901317 greatly increases both LXR and RXR binding. T he liver plays a central role in the control of whole-body lipid homeostasis, and hepatic lipid metabolism is continuously adjusted to fit the needs of the organism. This adaptation requires major adjustments in the hepatic metabolic gene program, including a strong upregulation of lipogenic gene expression in the fed state, whereas in the fasting state, the expression of genes involved in fatty acid oxidation as well as ketogenesis and hepatic glucose production is highly induced. Class II nuclear receptors (NRs), i.e., NRs forming heterodimers with retinoid X receptor (RXR), play a key role in coordinating these changes. They include the liver X receptor (LXR) (29, 57) and peroxisome proliferatoractivated receptor (PPAR) (32, 34, 41) families as well as farnesoid X receptor (FXR) (44, 55, 88), pregnane X receptor (PXR) (5, 33), vitamin D receptor (VDR) (43), constitutive androstane receptor (CAR) (3, 9, 23), and retinoic acid receptors (RARs) (13).The LXR family consists of the two subtypes, LXR␣ (NR1H3) and LXR␤ (NR1H2), both of which form obligate heterodimers with RXR. LXR-RXR heterodimers are reported to bind to LXR response elements (LXREs) that consist of a direct repeat of the core sequence 5=-AGGTCA-3= spaced by 4 nucleotides (DR4) (2,72,76,79,92). LXRs are activated by oxidized cholesterol derivatives and play an important role in the regulation of cholesterol homeostasis in the liver. Thus, pharmacological activation of LXR leads to the induction of several genes implicated in reverse cholesterol transport and mobilization of cholesterol, such as the ATP binding cassette (ABC) transporter genes Abca1, Abcg1, Abcg5, and Abcg8 and the apolipoprotein E gene (ApoE) (12,31,37,60,63,84). Furthermore, a recent genomewide study of LXR in human hepatoma cells showed that LXR also downregulates expression of the cholesterologenic genes for lanosterol 14␣-demethylase (Cyp51A1) and squalene synthase (Fdst1) (89). Moreover, LXR activation induces triglyceride synthesis partly through induction of the lipogenic transcription factors sterol regulatory element-binding protein 1c (SREBP-1c) (42,61,95) and carbohydrate response element-binding protein (ChREBP) (8) but also by direct activation of genes encoding lipogenic enzymes such as fatty acid synthase (Fasn), stearoyl coenzyme A (CoA) desaturase (Scd1), ...