Ursodeoxycholic acid (UDCA) is the current mainstay of treatment for various liver diseases including primary biliary cirrhosis. UDCA acts as a bile secretagogue, cytoprotective agent, immunomodulator, and inhibitor of cellular apoptosis. Despite this cumulative evidence of the cytoprotective and immunosuppressive effects of UDCA, both the target molecule and pathway of UDCA action remain unknown. We previously described that, in the absence of glucocorticoid ligand, UDCA activates the glucocorticoid receptor (GR) into DNA binding species but does not elicit its transactivational function in a transient transfection assay. Here we further studied the molecular mechanism of UDCA action and revealed that the ligand binding domain of the GR is responsible for UDCA-dependent nuclear translocation of the GR. Indeed, we demonstrated that UDCA acts on the distinct region of the ligand binding domain when compared with the classical GR agonist dexamethasone, resulting in loss of coactivator recruitment and differential regulation of gene expression by the GR. Our data clearly indicated that UDCA, at least in part via activation of the GR, suppresses NF-B-dependent transcription through the intervention of GR-p65 interaction. Together with the established clinical safety of UDCA, we may propose that UDCA could be a prototypical compound for development of a novel and selective GR modifier.
Ursodeoxycholic acid (UDCA)1 is the current mainstay of treatment for primary biliary cirrhosis, which is a chronic cholestatic liver disease characterized by the destruction of biliary epithelial cells (i.e. cholangiocytes), presumably by autoimmune mechanism(s) (1-3). This hydrophilic bile acid is reported to induce biochemical, histological, and prognostic improvement in patients with primary biliary cirrhosis in the virtual absence of adverse reactions (3). UDCA acts as a bile secretagogue and cytoprotective agent (1) and exerts diverse immunomodulatory actions in vitro: suppression of immunoglobulin, interleukin-2, interleukin-4, and interferon-␥ production from lymphocytes; attenuation of major histocompatibility complex expression on hepatocytes and cholangiocytes; increase in natural killer cell activity; and inhibition of eosinophil degranulation (1, 4 -9). Recently, it has been shown that UDCA inhibits cellular apoptosis via stabilization of the mitochondria membrane (10, 11). Despite this cumulative evidence of the cytoprotective and immunosuppressive effects of UDCA, both the target molecule and pathway of UDCA action remain unknown. The glucocorticoid receptor (GR) is a member of the nuclear receptors and an important transcriptional regulator involved in widely diverse physiological functions such as control of embryonic development, cell differentiation, and metabolic homeostasis (12, 13). Moreover, therapeutic activities of glucocorticoids are believed to inevitably be mediated by the GR (14). The nuclear receptors share several structural features (e.g. the ligand binding domain (LBD), DNA binding domain (DBD), and sev...