Regulation of Liver Metabolism by Fibroblast Growth Factor 19

Fibroblast Growth Factor (FGF) 19 is a postprandial enterokine up-regulated by bile acid receptor FXR upon bile acid uptake into the ileum. FGF19 inhibits hepatic bile acid synthesis through transcriptional repression of cholesterol 7 alpha-hydroxylase (CYP7A1) via a mechanism involving nuclear receptor Small Heterodimer Partner (SHP). Here, I show that two other nuclear receptors, Hepatocyte Nuclear Factor 4 alpha (HNF4 alpha) and Liver Receptor Homolog-1 (LRH-1), enable SHP binding to the Cyp7a1 promoter and therefore are important for negative feedback regulation of Cyp7a1. HNF4 alpha and LRH-1 are also crucial activators of Cyp7a1 transcription. They maintain active transcription histone marks on the Cyp7a1 promoter, whereas FGF19 down-regulates these marks in a SHP-dependent way. Secondly, I show that the MEK/ERK signaling pathway is an integral regulator of bile acid metabolism. ERK activity is necessary to maintain hepatic Shp and Cyp7a1 transcription at their physiologic levels. Inhibition of this pathway causes loss of Shp transcription by disrupting HNF4 alpha and LRH-1 binding to the Shp promoter. Independent from the effects on Shp, MEK/ERK inhibition induces Cyp7a1 transcription. Unexpectedly, the MEK/ERK pathway is not required for repression of Cyp7a1 by FGF19. Although this pathway is activated by FGF19 in livers of Fgf receptor 4 (Fgfr4)-deficient mice probably via other FGFRs, Cyp7a1 repression is largely impaired. Thus, I propose that a signaling mechanism uniquely regulated by FGFR4 must be responsible for FGF19-dependent repression of bile acid synthesis. In addition to its roles in bile acid metabolism, I also show that FGF19 stimulates hepatic protein and glycogen synthesis, but does not induce lipogenesis. The effects of FGF19 are independent of the activity of either insulin or the protein kinase Akt, and instead are mediated through a mitogen-activated protein kinase signaling pathway that activates components of the protein translation machinery and stimulates glycogen synthase activity. Mice lacking FGF15 (the mouse FGF19 ortholog) fail to properly regulate blood glucose and fail to maintain normal postprandial amounts of liver glycogen. FGF19 treatment restored the loss of glycogen in diabetic animals lacking insulin. Thus, FGF19 activates a physiologically important, insulin-independent endocrine pathway that regulates hepatic protein and glycogen metabolism.