Nutrition and Gene Regulation Desaturase-1 (SCD-1) Paul Cohen* and Jeffrey M. Friedman*
Transcription
Nutrition and Gene Regulation Desaturase-1 (SCD-1) Paul Cohen* and Jeffrey M. Friedman*
Nutrition and Gene Regulation Leptin and the Control of Metabolism: Role for Stearoyl-CoA Desaturase-1 (SCD-1)1 Paul Cohen* and Jeffrey M. Friedman*†2 *Laboratory of Molecular Genetics and †Howard Hughes Medical Institute, The Rockefeller University, New York, NY 10021 KEY WORDS: ● leptin ● obesity ● Metabolic Syndrome ● stearoyl-CoA desaturase obesity is BMI, which is equal to weight in kilograms, divided by the square of height in meters. According to this measure, a BMI ⱖ 25.0 is considered overweight and a BMI ⱖ 30.0 is considered obese. Obesity is not only affecting adults in greater numbers, but is an increasing concern in children and adolescents as well. Since 1976, the prevalence of overweight among children and adolescents in the US has more than doubled (7,8). This trend has been linked to a rise in the incidence of Type 2 diabetes and other sequellae of increased body weight in this age group (9). The close association between obesity and the disorders characteristic of the Metabolic Syndrome implies that effective treatment of obesity will provide marked health benefits by reducing the incidence of diabetes, coronary artery disease, and hypertension. While the public would welcome a therapy that could eradicate obesity, recent studies have shown that relatively modest weight loss in obese individuals, on the order of ⬃10 pounds, significantly reduces the severity of diabetes and other comorbid conditions (10,11). In addition to the well known components of the Metabolic Syndrome, obesity is also associated with an increased likelihood of osteoarthritis, cholelithiasis, sleep apnea, and cancer (5,12). A more recently appreciated component of the Metabolic Syndrome is nonalcoholic fatty liver disease (NAFLD),3 with a ⬎30-fold relative risk in obese individuals (13). While NAFLD is estimated to A growing health problem The effects of obesity have now permeated society, precipitating a public health emergency. Over 30% of adults in the United States report attempting to lose weight, and the diet industry generates billions of dollars in revenue each year (1,2). Obesity not only confers a painful social stigma, but is closely associated with morbidity and mortality (3,4). Data from actuarial tables and the Nurses Health Study have found a direct relationship between body weight and overall mortality (4). The relative risk of type II diabetes, coronary artery disease, and hypertension is closely linked to indices of obesity, and these disorders are so frequently found in association with obesity that the constellation of conditions has been called the Metabolic Syndrome or Syndrome X (5). In the United States, where the situation is perhaps most dire, nearly 30% of adults meet the cutoff for obesity and over 60% of adults meet the criteria for either overweight or obesity (6). The most widely used metric for assessing overweight and 1 Presented at the 6th Postgraduate Course on Nutrition entitled “Nutrition and Gene Regulation” Symposium at Harvard Medical School, Boston, MA, March 13–14, 2003. This symposium was supported by Conrad Taff Nutrition Educational Fund, ConAgra Foods, GlaxoSmithKline Consumer Healthcare, McNeil Nutritionals, Nestle Nutrition Institute, The Peanut Institute, Procter & Gamble Company Nutrition Science Institute, Ross Products Division–Abbott Laboratories, and Slim Fast Foods Company. The proceedings of this symposium are published as a supplement to The Journal of Nutrition. Guest editors for the supplement publication were: W. Allan Walker, Harvard Medical School, George Blackburn, Harvard Medical School, Edward Giovanucci, Harvard School of Public Health, Boston, MA, and Ian Sanderson, University of London, London, UK. 2 To whom correspondence should be addressed. E-mail: friedj@mail.rockefeller.edu. 3 Abbreviations used: ACAT, acyl CoA:cholesterol acyltransferase; ACC, acetyl CoA carboxylase; CPT-1, carnityl palmitoyltransferase-1; DGAT, acyl CoA: diacylglycerol acyltransferase; NAFLD, nonalcoholic fatty liver disease; PPAR␣, peroxisome proliferator-activated receptor ␣; SCD-1, stearoyl-CoA desaturase-1; SREBP-1, sterol regulatory element-binding protein-1. 0022-3166/04 $8.00 © 2004 American Society for Nutritional Sciences. 2455S Downloaded from jn.nutrition.org by guest on June 9, 2014 ABSTRACT The incidence of obesity has increased sharply in recent years, making it one of the most urgent public health concerns worldwide. The hormone leptin is the central mediator in a negative feedback loop regulating energy homeostasis. Leptin administration leads to reduced food intake, increased energy expenditure, and weight loss. Leptin also mediates unique metabolic effects, specifically depleting lipid from liver and other peripheral tissues. While elucidation of leptin’s role has permitted a more detailed view of the biology underlying energy homeostasis, most obese individuals are leptin resistant. A more complete understanding of the molecular components of the leptin pathway is necessary to develop effective treatment for obesity and the Metabolic Syndrome. We review here studies on the identification of one such component, stearoyl-CoA desaturase-1 (SCD-1), as a gene specifically repressed by leptin and discuss the role of this process in mediating the metabolic effects of leptin. Data indicate that pharmacologic manipulation of SCD-1 may be of benefit in the treatment of obesity, diabetes, hepatic steatosis, and other components of the Metabolic Syndrome. J. Nutr. 134: 2455S–2463S, 2004. 2456S SUPPLEMENT affect 10 –24% of the population, the prevalence among obese individuals has been estimated to be as high as 74% (14). NAFLD, which is believed to be the most prevalent form of liver disease worldwide, can cause hepatic steatosis or fatty liver in its most benign form, but can progress to hepatitis, fibrosis, cirrhosis, and liver failure (14). Given the myriad health problems associated with obesity and the huge burden it places on obese individuals and society as a whole, finding new, effective treatments is imperative. A biological basis for body weight Metabolic effects of leptin Leptin regulates energy expenditure and metabolism by exerting specific and unique metabolic effects. Several lines of evidence indicate that leptin’s actions are not the result of its anorectic effects alone. For instance, ob/ob mice that have been food restricted to the level that leptin treated mice voluntarily consume (pair-fed) show smaller decreases in body weight and size of adipose depots (31,46). Moreover, leptin treatment causes the specific loss of fat mass, whereas food restriction depletes both lean and fat mass (31,32). In addition, food restriction is associated with a compensatory decrease in energy expenditure, which does not occur in response to leptin-induced hypophagia (47). Leptin-deficient humans and ob/ob mice not only accumulate significant amounts of triglyceride in adipose tissue, but also in liver, muscle, and other peripheral tissues. The build-up of lipid in nonadipose sites, such as liver, contributes to many of the health consequences of obesity such as insulin resistance and NAFLD, and has been termed lipotoxic disease (48 –50). Leptin, much more potently than pair-feeding, depletes lipid from these sites and Downloaded from jn.nutrition.org by guest on June 9, 2014 In basic terms, obesity, a disorder of energy homeostasis, develops when energy intake exceeds energy expenditure. One view, popular among the public, is that obesity is the result of a lack of willpower and gluttony, coupled with extreme laziness. An alternative theory posits that weight is maintained by a precise physiological mechanism and that obesity is the result of alterations in this biological pathway. The latter view has been validated by the discovery of a homeostatic circuit regulating appetite and body weight (1). The biological basis of this endocrine pathway is best appreciated by the case history that follows. A child from a consanguineous Pakastani pedigree developed morbid obesity, marked hyperphagia, and severe hyperinsulinemia beginning in infancy. By age 4 y, he weighed over 90 pounds and had 57% body fat. This child was found to have a homozygous mutation in the gene encoding leptin (see below), an adipose tissue derived hormone (15,16). Replacement of leptin produced profound effects. After 2 years of leptin therapy, this child was transformed from a morbidly obese 4-y-old to a moderately overweight 6-y-old, weighing just over 70 pounds with 35.5% body fat (6,16). The effects of leptin on this child, and his older, equally affected first cousin, provide irrefutable evidence that body weight is under biological control (17). Leptin, the hormone that these children congenitally lack, is now appreciated to be the central mediator in an endocrine circuit regulating energy homeostasis (18). Parabiosis studies on the morbidly obese ob/ob and db/db mouse strains indicated that ob/ob mice lacked a circulating factor regulating appetite and energy expenditure and that db/db mice lacked the ability to respond to that factor (19). This hypothesis was validated with the positional cloning of the mutant gene product in ob/ob mice in 1994, which was shown to encode an adipose tissue-derived hormone, named leptin (20). Like the human counterparts, ob/ob mice are morbidly obese and massively hyperphagic, with an approximately 3-fold increase in body weight and 2-fold increase in food intake relative to lean littermates. In addition, these animals are insulin resistant and diabetic, and accumulate massive amounts of lipid in peripheral tissues including the liver. Cloning of the mutant gene in db/db mice showed that these mice had defects in the leptin receptor, which has 5 splice variants (ObRa– e) (21–24). The signaling form of the leptin receptor, Ob-Rb, is expressed at highest levels in hypothalamic nuclei (25–28). Lesioning studies performed over 50 y ago identified these same nuclei as serving a critical role in energy balance (29). In normal individuals, leptin is secreted from adipose tissue and communicates the body’s nutritional status to the hypothalamus, which coordinates food intake and energy expenditure appropriately. Leptin administration in ob/ob and wild-type mice showed that leptin acts as an afferent signal in a negative feedback loop regulating adiposity, leading to decreased food intake, increased energy expenditure, and weight loss (30 –33). Leptin also acts as a signal of nutritional deprivation, with low leptin levels initiating an adaptive response to conserve en- ergy, manifested by hyperphagia, decreased energy expenditure, and shutdown of the reproductive and other endocrine axes (34). Thus, ob/ob mice, as well as leptin-deficient humans, exist in a state of perceived starvation, characterized by hyperphagia without satiety. Since the identification of leptin and its receptor, the physiological circuit controlling energy homeostasis has become increasingly well understood, and the major features of this pathway are summarized here (35). Leptin, acting via its receptor in the hypothalamus, activates an anorexigenic pathway mediated by neurons producing pro-opiomelanocortin and cocaine and amphetamine related transcript and inhibits an orexigenic pathway mediated by neurons producing neuropeptide Y and agouti related protein (33,36 –39). These pathways interact with other brain centers and metabolic circuitry to coordinate appetite and modulate efferent signals to the periphery regulating metabolism and energy expenditure (40). While elucidation of the role of leptin has permitted a progressively more detailed view of the biology underlying energy homeostasis, studies in humans indicate that most overweight and obese individuals will not respond as potently to leptin as ob/ob mice or the child described above. Only about 10 humans with mutations in the leptin gene leading to total leptin deficiency have been described (15,41). An additional unknown number of individuals have insufficient leptin production resulting from heterozygous mutations in the leptin gene (42). In general, however, plasma leptin levels are increased proportionately to body mass and fall following weight loss (43,44). For the most part, the highest leptin levels are found in the most obese individuals. While about 5–10% of obese individuals are thought to be obese due to insufficent leptin production, the remaining 90 –95% are believed to be leptin resistant (43). Clinical trials of leptin have shown that obese individuals do lose weight in a dose-dependent manner. However, its effects are highly variable with certain patients losing as much as 15–20 kg and others losing no weight at all (45). Considering that most obese humans are leptin resistant, these findings are to be expected. While leptin resistant patients may still prove to benefit from leptin, as insulin-resistant diabetics can benefit from insulin, on its own, leptin is not likely to significantly alleviate obesity. Thus, the development of novel therapies for obesity, which are so urgently needed, requires a fuller understanding of the molecular components of the leptin pathway. ROLE FOR SCD-1 IN MEDIATING THE METABOLIC EFFECTS OF LEPTIN 2457S Leptin-specific repression of stearoyl-CoA desaturase-1 (SCD-1) in liver To elucidate the mechanism whereby leptin reduces hepatic lipid content, we used microarrays to identify genes in liver whose expression was specifically modulated by leptin treatment, hypothesizing that this set of genes would include molecules involved in leptin’s metabolic effects (55). To that end, ob/ob mice were followed over a time course of weight loss induced by either leptin administration or saline treatment with pair-feeding for 2, 4, or 12 d. As an additional control, free-fed ob/ob mice treated with saline were also studied. As described before, leptin treated mice lost significantly more weight and showed a much more dramatic correction of hepatic steatosis than pair-fed mice, providing gross evidence of the metabolic actions of leptin that we wished to uncover at the molecular level. Liver RNA was isolated from each of these groups and hybridized to Affymetrix oligonucleotide microarrays, containing 6500 murine genes. The data from these 8 experiments generated over 52,000 data points, necessitating novel analytical approaches to find meaningful trends in this data set (Fig. 1). Previous work from our group and others has shown that cluster analysis is a highly robust method for identifying groups of genes with coordinate patterns of expression from these, and far larger data sets (56,57). Fifteen clusters of genes with distinct patterns of expression were identified in this data set, 6 of which correspond to genes specifically regulated by leptin, but not pair- feeding. While cluster analysis was able to determine groups of liver genes specifically modulated by leptin administration, this list still contained a few hundred genes. Therefore, to identify specific genes for further functional analysis, we used a more directed computational approach to select genes that are particularly repressed during leptin-mediated weight loss (Fig. 1). An algorithm was created that ranked genes based on the extent to which their expression was (1) increased in ob/ob liver compared to wild-type (2) repressed by leptin treatment, and (3) maximally different between leptin treatment and pair-feeding FIGURE 1 Algorithm for identifying and ranking leptin repressed genes. To explore gene expression in response to leptin administration, ob/ob mice were treated with either leptin or saline with pair-feeding over a time course of 2, 4, or 12 d. As additional controls, free fed saline treated and free fed untreated ob/ob and wild-type mice were also studied. Liver RNA was isolated from each of these groups and hybridized to Affymetrix murine 6500 gene oligonucleotide arrays. The data from each of the 8 ob/ob experiments was referenced to untreated wild-type liver generating a total of 52,000 data points. To extract biologically meaningful data from this massive data set we developed an algorithm that identified and ranked genes specifically repressed by leptin, based on how closely they adhered to the following criteria: (1) increased expression in ob/ob liver, (2) reduced expression upon leptin administration, and (3) maximally different expression between leptin and pair-feeding. This approach generated a prioritized list of genes uniquely repressed by leptin, which may be involved in mediating the novel metabolic actions of the hormone. (55). Specifically, we selected genes whose expression was increased in ob/ob relative to wild-type and corrected by leptin administration. This approach allowed us to generate a prioritized list of genes uniquely repressed by leptin, which were candidates for mediating the novel metabolic actions of the hormone. The gene encoding SCD-1 ranked the highest in this analysis. SCD-1 is the rate limiting enzyme in the biosynthesis Downloaded from jn.nutrition.org by guest on June 9, 2014 thereby reverses the associated adverse effects (51). Whereas food restriction leads to a rise in serum free fatty acids, leptinmediated weight loss is not associated with a rise in free fatty acids or ketones, suggesting a unique mechanism of fatty acid oxidation (51,52). In aggregate, these findings suggest that leptin causes weight loss by enacting a novel metabolic program, distinct from food restriction on both a physiological and molecular basis. Central administration of leptin and generation of mice with a neuron-specific knockout of ObR indicate that these metabolic effects are largely mediated by a still uncharacterized efferent signal emanating from the central nervous system, though direct effects on peripheral tissues may also be important (30,33,47,53). In the absence of leptin, ob/ob mice develop massively enlarged livers engorged with lipid, and leptin replacement preferentially corrects the liver pathology in these mice, much more potently than food restriction (46). Leptin significantly reduces hepatomegaly and liver triglyceride levels, and after 12 d of leptin replacement, an ob/ob liver is histologically virtually indistinguishable from wild-type. An equivalent period of pair-feeding, however, leads to a much less dramatic reduction in triglyceride, with a moderate amount of lipid vacuolation still evident on histology (54). These dramatic effects of leptin prompted us to examine the molecular basis by which leptin specifically depletes hepatic lipid. We reasoned that molecules involved in this pathway might be broadly relevant to body weight homeostasis. 2458S SUPPLEMENT SCD-1 repression is crucial in mediating the metabolic effects of leptin To determine the extent to which leptin’s metabolic effects are mediated by repression of SCD-1, we studied asebia mice (abJ/abJ) (71). Positional cloning of the mutant gene in these mice identified a genomic deletion of the first 4 exons of the SCD-1 gene (72). These mice produce no functional SCD-1 mRNA or protein, though expression of SCD-2 remains unaltered. Mice lacking SCD-1 have also been generated by targeted deletion (SCD-1⫺/⫺), and the phenotype of abJ/abJ and SCD-1⫺/⫺ mice is nearly indistinguishable (73,74). The asebia mutants, first described in 1965, have ocular and cutaneous abnormalities, including an absence of sebaceous glands, believed to be secondary to defective synthesis of wax esters and other lipids (71). More recently these animals were shown to have markedly decreased synthesis of palmitoleic and oleic acid and subsequent reductions in hepatic triglycerides, cholesterol esters, and VLDL synthesis (75). The monounsaturated fatty acid products of SCD-1 are among the most abundant lipids in rodent and human diets, and thus, these findings were initially puzzling. However, further study confirmed a strict requirement for endogenous synthesis of these lipids, as even diets supplemented with high levels of monounsaturated fats could not correct the defects in asebia mice (76). While the eye and skin phenotypes in these mice were striking, we immediately appreciated that SCD-1 deficient mice appeared visibly lean relative to their littermates. Despite normal body weight, asebia mice have significant reductions in body fat relative to littermate controls. In keeping with their reduced adiposity, these mice also have decreased plasma leptin levels (55). Next, we asked whether the absence of SCD-1 could correct the genetic obesity resulting from leptin deficiency. Because suppression of hepatic SCD-1 RNA levels and enzymatic activity was found to be one of the markers of leptin treatment, we hypothesized that ob/ob mice lacking SCD-1 (abJ/abJ;ob/ob) would resemble leptin treated ob/ob mice. Double mutant abJ/abJ;ob/ob mice showed a dramatic reduction in body weight at all ages compared to ob/ob littermate controls, weighing 30% less by 16 wk of age (55). Leptin treatment of ob/ob mice for 12 d produced a similar decrease in body weight. Body composition analysis showed a dramatic reduction in percent body fat in double mutant animals, though they remained significantly more obese than wild-type littermates. abJ/abJ;ob/ob mice also showed a significant increase in lean body mass relative to ob/ob mice (55). This observation confirmed that the reduced adiposity in ob/ob mice lacking SCD-1 was not the result of a more general defect in growth or development. Mice lacking SCD-1 are also protected from dietary obesity, as shown by studies in SCD-1⫺/⫺ knockout mice. The weight of every adipose depot, with the exception of brown fat, was significantly lower in high-fat fed knockout mice than in high-fat fed controls (74). To explore the mechanism by which mice lacking SCD-1 are resistant to obesity, we evaluated the 2 most obvious possibilities, decreased food intake and/or increased energy expenditure. Unexpectedly, we found that mice lacking SCD-1 ate significantly more than littermate controls (55). Asebia mice ate a similar amount of food as ob/ob mice, which weigh approximately twice as much. Double mutant abJ/abJ; ob/ob mice ate even more still, consuming ⬎9 g/d. The finding of significantly increased food intake, in the setting of reduced adiposity, led us to predict that mice lacking SCD-1 were burning more energy. We measured energy expenditure by indirect calorimetry. Asebia mice of both sexes demonstrated significantly greater total and resting oxygen consumption (surrogates for total and basal metabolic rate) than littermate controls (55). ob/ob mice are known to be markedly hypometabolic, since in the absence of leptin, they exist in a state of perceived starvation and actively conserve energy. However, we found that ob/ob mice lacking SCD-1 had a complete correction of this hypometabolic phenotype, with energy expenditure equivalent to, or even greater than, wild-type littermates. SCD-1 and fatty liver SCD-1 was identified via a screen to elucidate the molecular basis by which leptin specifically depletes hepatic lipid. As leptin administration potently reduces hepatic lipid while repressing the expression of a number of genes including SCD-1, we analyzed to what extent the absence of SCD-1 alone could protect ob/ob mice from fatty liver disease (55). Livers from double mutant abJ/abJ;ob/ob mice were grossly and histologically indistinguishable from those of wild-type mice. In addition, triglyceride levels were reduced more than 3-fold in abJ/abJ;ob/ob livers relative to ob/ob, to an amount equivalent Downloaded from jn.nutrition.org by guest on June 9, 2014 of monounsaturated fats, which in conjunction with NADPH, cytochrome b5 reductase, and cytochrome b5 introduces a single double bond into its substrates palmitic (16:0) and stearic acid (18:0) to generate the products palmitoleic (16:1) and oleic acid (18:1) (58,59). These products are the most abundant fatty acids found in triglycerides, cholesterol esters, and phospholipids. SCD-1 is predominantly located in the endoplasmic reticulum, where it undergoes rapid turnover in response to a variety of nutritional and hormonal signals (60). The gene is also transcriptionally regulated by a number of factors including sterol regulatory element-binding protein-1 (SREBP-1) and PUFA (62,63). SCD-1, which is widely expressed, is one of four characterized SCD genes in mice, which are arranged in a cluster on chromosome 19 (63). Humans have a single characterized SCD gene, with 85% homology to murine SCD-1 (64). SCD homologs have also been identified in yeast, flies, and worms, indicating that this gene has served a vital metabolic function during evolution (65– 67). To confirm that this algorithm accurately identified leptin repressed genes, SCD-1 RNA levels, enzymatic activity, and enzymatic product levels were measured in an identical but independent time course (55). SCD-1 RNA levels were highly elevated in untreated ob/ob liver. SCD-1 RNA levels in leptin treated ob/ob mice were normalized at 2 d and by 4 d fell to levels below that of lean controls, a result consistent with previous studies (68,69). Pair-fed mice showed a smaller and delayed decrease in SCD-1 gene expression. These trends were further reflected in measures of enzymatic activity. SCD enzymatic activity was elevated over 7-fold in livers of untreated ob/ob mice relative to wild-type. Leptin treatment normalized SCD enzymatic activity, while pair-feeding reduced enzymatic activity to a lesser extent. Levels of hepatic monounsaturated 16:1 and 18:1 fatty acids, the products of SCD-1, were elevated in ob/ob mice and normalized by 12 d of leptin treatment, but not by pair-feeding. Leptin also preferentially normalized desaturation indices (ratios of 16:1/16:0 and 18:1/18:0 levels), which are indicators of SCD enzymatic activity. These findings confirmed that we had identified a molecular target of the metabolic effects of leptin. While the effects of leptin on SCD-1 may be downstream of the hormone’s effects on insulin and/or neuroendocrine function, leptin also represses SCD-1 in wild-type rodents, suggesting that the regulation of this enzyme by leptin may be relatively specific (70). ROLE FOR SCD-1 IN MEDIATING THE METABOLIC EFFECTS OF LEPTIN of SCD-1, are required for triglyceride and cholesterol ester synthesis and VLDL production (75). We hypothesized that in the absence of SCD-1, lipid synthesis and VLDL production are blocked, and that as a default, fat is oxidized. Histological and quantitative analysis confirmed that hepatic lipid storage was significantly reduced in abJ/abJ;ob/ob mice. We next assessed hepatic VLDL production by injecting mice with tyloxapol, an inhibitor of VLDL hydrolysis, and measuring plasma triglyceride levels over time (55,88). Since VLDL hydrolysis is inhibited by tyloxapol, plasma triglycerides rise in a linear fashion over time, with the slope of the line denoting VLDL production. While VLDL synthesis is markedly increased in ob/ob mice, its production is reduced in abJ/abJ;ob/ob mice to levels comparable to littermate controls. Therefore, in the absence of SCD-1, hepatic lipid storage and VLDL production are impaired, and as a default, fatty acids are oxidized. The finding of reduced adiposity and increased energy expenditure, in the setting of normal to increased food intake, is suggestive of enhanced fatty acid oxidation. In addition, mice lacking SCD-1 have increased plasma ketone bodies, another marker of increased fatty acid oxidation (55). Moreover, expression profiling of SCD-1⫺/⫺ mice demonstrated increased expression of genes encoding enzymes involved in fatty acid oxidation (74). The schematic in Figure 2 illustrates one mechanism whereby a deficiency in SCD-1 might lead to increased fatty acid oxidation. In the absence of SCD-1, or when SCD-1 is repressed by leptin treatment, saturated fatty acyl CoAs cannot be desaturated into monounsaturated fatty acyl CoAs, and would be expected to accumulate. Saturated, but not monounsaturated, fatty acyl CoAs potently allosterically inhibit acetyl CoA carboxylase (ACC), the enzyme that converts acetyl CoA into malonyl CoA, an intermediate in fatty acid Mechanism by which SCD-1 deficiency protects against obesity and fatty liver SCD-1 appears to be a pivotal metabolic control point, and mice deficient in this enzyme are resistant to both hepatic steatosis and obesity. These findings are due to markedly increased energy expenditure in SCD-1 deficient mice. To gain a deeper understanding of this process, we have been studying the mechanism underlying increased energy expenditure in animals lacking SCD-1. As a starting point, we considered the possible fates of hepatic fatty acids. In the liver, fatty acids, which are esterified to glycerol in triglycerides or cholesterol in cholesterol esters, can either 1) accumulate leading to increased hepatic lipid content or steatosis, 2) be packaged into VLDL for transport to other tissues, or 3) be oxidized. Monounsaturated fatty acids, the enzymatic products FIGURE 2 Basis for increased energy expenditure in mice lacking SCD-1. Proposed mechanism for the metabolic effects mediated by SCD-1 deficiency. In the absence of SCD-1, synthesis of triglycerides and VLDL is blocked, leading to decreased hepatic lipid storage and export. A lack of SCD-1 causes an increase in the pool of saturated fatty acyl CoAs, which allosterically inhibit acetyl CoA carboxylase (ACC). Inhibition of ACC reduces levels of malonyl CoA, a metabolite which normally inhibits the mitochondrial carnityl palmitoyl shuttle system, the rate-limiting step in the import and oxidation of fatty acids in mitochondria. Decreased malonyl CoA thus de-represses fatty acid oxidation, leading to increased burning of fat. Downloaded from jn.nutrition.org by guest on June 9, 2014 to that in wild-type livers. Triglyceride levels in abJ/abJ mice were reduced still further to levels below that of wild-type. Thus, downregulation of SCD-1 expression and activity plays a major role in leptin-mediated depletion of hepatic lipid. The resistance to hepatic lipid accumulation in ob/ob mice lacking SCD-1 prompted us to examine whether hepatic steatosis in other clinical settings can be suppressed by SCD-1 deficiency. Lipodystrophy, defined by the partial or complete absence of adipose tissue, is associated with hepatic steatosis, severe insulin resistance, diabetes, and leptin deficiency (77,78). Human lipodystrophy can be either congenital or acquired, and is emerging as a significant problem in a substantial number of HIV patients, likely as a secondary effect of highly active antiretroviral therapy (79). In the absence of adipose tissue, triglyceride accumulates in liver, heart, muscle, and other tissues. A number of mouse models of lipodystrophy exist, with the best characterized being the aP2-nSREBP-1c transgenic and the A-ZIP fatless mice (80,81). The existence of these mouse models allowed scientists to determine whether the metabolic defects in lipodystrophy were specifically due to the absence of adipose tissue as a triglyceride storage depot or due to the absence of an adipose-derived factor. The answer appears to be the latter as leptin administration markedly improved insulin resistance and diabetes in both lipodystrophic mice and humans (82,83). In addition, fat cell transplants from wild-type, but not ob/ob, mice into lipodystrophic mice ameliorated the diabetic phenotype (84,85). Furthermore, in lipodystrophic mice and humans, physiological doses of leptin also correct the enlarged fatty liver (86). We therefore examined whether SCD-1 overexpression contributes to the hepatic steatosis of lipodystrophy. We found that liver SCD-1 expression and activity were increased in aP2-nSREBP-1c transgenic mice and repressed by leptin in a dose-dependent manner (87). Intracerebroventricular administration of leptin, at a dose that had no effect when delivered peripherally, completely normalized SCD activity in lipodystrophic mice, indicating that the effects of leptin on liver SCD-1 are likely mediated by central action (87). In a previous study, SCD-1 among several other lipid biosynthetic genes was also found to be overexpressed in aP2-nSREBP-1c transgenic liver and repressed by leptin (82). To assess the specific role for SCD-1 in the hepatic steatosis of lipodystrophy double mutant, lipodystrophic mice lacking SCD-1 (abJ/abJ;aP2nSREBP-1c tg) were generated. Analysis of these mice found that SCD-1 deficiency significantly improves, but does not completely correct, the fatty liver associated with lipodystrophy (87). Additional studies are underway to evaluate the importance of SCD-1 in other models of hepatic steatosis, such as alcohol-induced fatty liver. 2459S 2460S SUPPLEMENT for triglyceride hydrolysis, also display reduced body weight and fat mass (103). Finally, ob/ob mice overexpressing apolipoprotein C1, which has been proposed to inhibit hydrolysis of VLDL triglyceride, demonstrate a nearly total correction in obesity (104). A role for SCD-1 in other components of the metabolic syndrome Given the effects of SCD-1 on lipid metabolism and obesity, repression of this enzyme may also protect from other components of the Metabolic Syndrome, such as diabetes and atherosclerosis. While diabetes has traditionally been considered a disorder of carbohydrate metabolism, more recent work has indicated that diabetes is fundamentally a disease of lipid metabolism (48,49). Increased deposition of lipid in tissues other than white fat contributes to the development of insulin resistance and diabetes (50). SCD-1⫺/⫺ mice show increased glucose and insulin tolerance, indicating that an inhibition of SCD-1 activity may be protective against diabetes (74). However, SCD-1 deletion on its own does not appear to improve the severe form of diabetes seen in lipodystrophic animals (87). Studies are currently in progress to determine the effects of SCD-1 repression in other insulin-sensitive tissues and the specific effects of SCD-1 deficiency on the insulin signaling cascade. Mice lacking SCD-1 have markedly reduced rates of both triglyceride and cholesterol ester synthesis as well as reduced levels of VLDL production (75). While effects on triglyceride metabolism appear to confer protection from obesity in the absence of SCD-1, the effects on cholesterol and lipoprotein metabolism suggest that SCD-1 deficiency may also stave off atherosclerosis. Oleic acid, the product of SCD-1, is the preferred substrate for acyl CoA:cholesterol acyltransferase (ACAT), the rate-limiting enzyme in cholesterol esterification (105). Mice lacking SCD-1 have decreased synthesis of cholesterol esters despite normal ACAT activity (75). In addition, hypertriglyceridemia is associated with increased SCD-1 activity in the hyplip mouse, a model of hyperlipidemia, which has increased SCD-1 activity (106). Furthermore, in a human cohort, differences in SCD-1 activity explained 44% of the variance in triglyceride levels (106). These findings suggest that increased SCD levels and activity might promote atherosclerosis, whereas inhibition of SCD-1 may protect against atherosclerosis. This hypothesis is supported by the finding that increased levels of SCD-1 inhibit ABCA1-mediated cholesterol efflux (107). However, to formally demonstrate a role for SCD-1 in atherosclerosis, genetic studies are in progress in which mice lacking SCD-1 are being bred to mouse models of atherosclerosis such as apoE or LDL receptor knockout mice. Importance of stearoyl-CoA desaturases in other tissues While repression of SCD-1 has been shown to be an important component of leptin’s metabolic actions, leptin may also have effects on SCD-1 and other SCD isoforms in other tissues. Leptin administration in ob/ob mice results in the reduction of lipid in tissues other than liver, such as heart and skeletal muscle (94,108). During a survey of the effects of leptin in other tissues, we found that while the RNA levels of SCD-1 and SCD-2 were not altered by leptin deficiency in ob/ob hearts, SCD activity and levels of monounsaturated fatty acids were increased. This observation led to the cloning of SCD-4, a novel SCD isoform expressed exclusively in the heart (109). SCD-4 RNA levels are elevated in ob/ob heart, Downloaded from jn.nutrition.org by guest on June 9, 2014 biosynthesis (89 –91). This enzymatic reaction plays a critical role in directing the cell towards either lipid synthesis or oxidation. Malonyl CoA normally inhibits carnityl palmitoyltransferase-1 (CPT-1), the rate limiting enzyme in the shuttle of fatty acids from the cytosol, where they are synthesized, into the mitochondria, where they are oxidized (92). When malonyl CoA levels fall, however, CPT-1 is de-repressed and fatty acids can enter mitochondria and be oxidized. As indicated in Figure 2, saturated fatty acyl CoAs would be expected to accumulate in the absence of SCD-1 and inhibit ACC. Inhibition of ACC would lead to a concomitant fall in malonyl CoA, which would thereby relieve the inhibition of CPT-1 and direct fatty acids into mitochondria, where they are burned for energy. In addition, a fall in malonyl CoA would also decrease fatty acid biosynthesis. Several alternative mechanisms could also account for the increased energy expenditure in the setting of SCD-1 deficiency. Inhibition of SCD-1 could increase the levels of a peroxisome proliferator-activated receptor ␣ (PPAR␣) ligand, leading to increased peroxisomal fatty acid oxidation. In support of this possibility, expression analysis in SCD-1⫺/⫺ mice detected increased levels of the mRNA encoding acyl CoA oxidase, the rate-limiting enzyme in peroxisomal oxidation (74). Moreover, PPAR␣ is required for leptin-mediated fatty acid depletion in the liver (93). Decreased SCD-1 activity could also alter the levels of ligands for other nuclear hormone receptors important in lipid homeostasis. SCD-1 deficiency may be associated with increased activity of AMP-activated protein kinase, a signaling molecule that has been shown to stimulate fatty acid oxidation following leptin administration (94). SCD-1 deficiency could also alter phospholipid composition, thereby affecting membrane fluidity and signal transduction. Repression of SCD-1 could additionally be associated with direct or indirect effects of fatty acids on uncoupling proteins. Moreover, the fur and lipid abnormalities associated with defects in SCD-1 could be associated with increased energy dissipation. Experiments are currently underway to evaluate each of these possibilities. Interestingly, inhibition of other genes in the same metabolic pathway as SCD-1 is also associated with increased energy expenditure and resistance to obesity, providing further evidence that manipulation of this pathway may be therapeutically relevant. Mice with targeted mutations in ACC-2 have decreased levels of malonyl CoA, increased fatty acid oxidation, and are protected from obesity (95). Furthermore, the drug C75, which causes weight loss by both a central effect on appetite and a peripheral effect on metabolism, is a fatty acid synthase inhibitor, but also acts in part by directly de-repressing CPT-1 (96,97). Deletion of acyl CoA:diacylglycerol acyltransferase (DGAT), which catalyzes the final step in the biosynthesis of triglycerides from fatty acids, also produces sebaceous gland defects and leads to a phenotype very similar to that of mice lacking SCD-1 (98,99). Interestingly, a polymorphism in the promoter of the DGAT gene, leading to decreased expression, has been associated with reduced BMI in Turkish women (100). Modulation of these gene products may prevent obesity by a similar mechanism to that proposed for SCD-1 in Figure 2. In the liver, triglycerides formed via this pathway can be packaged in VLDL and exported to adipose tissue and other sites. A number of genetic alterations, inhibiting hydrolysis and consequent delivery of VLDL triglyceride, also lead to reduced adiposity. Mice lacking the VLDL receptor are lean, and breeding of this mutation on to the ob/ob background markedly corrects obesity (101,102). 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Future experiments are needed to determine whether SCD-1 or other SCD isoforms are functionally important in other tissues. Studies also need to further explore what role SCD-1 plays in other aspects of the metabolic syndrome, such as diabetes and atherosclerosis. Further experimentation is necessary to determine whether the absence of SCD-1 confers any adverse health risks. Increased fatty acid oxidation may increase the levels of toxic free radicals, which could predispose to cancer or reduced longevity (110). In addition, global deletion of SCD-1, while beneficial from a metabolic standpoint, has deterimental effects on the skin, hair, and eye. However, mice with heterozygous mutations in SCD-1 have none of these abnormalities, despite a 50% reduction in SCD activity, suggesting that a partial reduction in SCD activity may be beneficial (73). 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