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Copyright © 2002, American Society for Investigative Pathology Increased Carbon Tetrachloride-Induced Liver Injury and Fibrosis in FGFR4-Deficient Mice From the Department of Biochemistry and Biophysics and the Center for Cancer Biology and Nutrition,* Institute of Biosciences and Technology, Texas A&M University System Health Science Center, Houston; and the Graduate School of Biomedical Sciences,† The University of Texas-Houston Health Science Center, Houston, Texas Accepted August 15, 2002. This article has been cited by other articles in PMC.Abstract Carbon tetrachloride (CCl4) intoxification in rodents is a commonly used model of both acute and chronic liver injury. Recently, we showed that mice in which FGFR4 was ablated from the germline exhibited elevated cholesterol metabolism and bile acid synthesis coincident with unrepressed levels of cytochrome P450 7A (CYP7A), the rate-limiting enzyme in cholesterol disposal. Of the four fibroblast growth factor (FGF) receptor genes expressed in adult liver, FGFR4 is expressed specifically in mature hepatocytes. To determine whether FGFR4 plays a broader role in liver-specific metabolic functions, we examined the impact of both acute and chronic exposure to CCl4 in FGFR4-deficient mice. Following acute CCl4 exposure, the FGFR4-deficient mice exhibited accelerated liver injury, a significant increase in liver mass and delayed hepatolobular repair. Chronic CCl4 exposure resulted in severe fibrosis in livers of FGFR4-deficient mice compared to normal mice. Analysis at both mRNA and protein levels indicated an 8-hour delay in FGFR4-deficient mice in the down-regulation of cytochrome P450 2E1 (CYP2E1) protein, the major enzyme whose products underlie CCl4-induced injury. These results show that hepatocyte FGFR4 protects against acute and chronic insult to the liver and prevents accompanying fibrosis. The results show that FGFR4 acts by promotion of processes that restore hepatolobular architecture rather than cellularity while limiting damage due to prolonged CYP2E1 activity. Metabolism in the liver protects tissues in higher organisms from potentially harmful blood-borne environmental chemicals. Ironically, the metabolic products of detoxification reactions that protect other tissues from effects of the primary toxicant can be destructive to the liver when in excess or chronically present. Administration of carbon tetrachloride (CCl4) to rodents is a widely used model to study mechanisms of hepatic injury. CCl4 causes hepatocyte injury that is characterized by centrilobular necrosis that is followed by hepatic fibrosis. Systemic administration of growth factors and cytokines, epidermal growth factor (EGF), 1 hepatocyte growth factor (HGF), 2 and interleukin-6 (IL-6) in IL-6-deficient mice 3 reduces CCl4-induced hepatic injury. It is unclear whether the systemic application is through direct activation of receptor signaling systems in hepatocytes or mediated indirectly by other liver cell types or organ sites. Moreover, EGF, HGF, and IL-6 play positive roles in the regenerative response of the liver to cellular loss from partial hepatectomy or damage. Thus, it is difficult to dissect a direct role of the receptor signaling systems in modulation of hepatocyte-specific, metabolic-induced hepatic damage from enhanced restoration of liver cellularity through delayed apoptosis or enhanced cell division. The pericellular matrix-linked heparan sulfate-fibroblast growth factor (FGF) receptor complex is an intrinsic sensor of perturbation and remodeling in the extracellular environment. 4 One or more members of the family of polypeptide ligands, transmembrane tyrosine kinase, and heparan sulfate chains appear present in all tissues. The system plays key roles in sensing and signaling changes during embryonic development and maintenance of homeostasis among cellular compartments in the adult. 4,5 Of the four FGFR isotypes and their numerous splice variants, only FGFR4 is expressed in mature hepatocytes. 6 The deletion of FGFR4 from the genome causes no obvious developmental abnormalities in mice, including the liver. 7,8 Moreover, the livers of FGFR4-deficient mice regenerate on schedule after partial hepatectomy that suggests that either FGFR4 is compensated for or plays no key role in the regenerative response. 8 Despite the lack of effect on development and regeneration, FGFR4-deficient mice exhibit a chronically depleted gall bladder and an elevated pool and fecal excretion of bile acids. 8 The elevated cholesterol metabolism and bile acid synthesis was coincident with unrepressed levels of CYP7A, the rate-limiting enzyme in cholesterol disposal. This indicated that FGFR4 signaling interfaces with metabolite-controlled transcription networks in hepatocytes, independent of liver cell proliferation. Here we show that the absence of FGFR4 resulted in accelerated and increased liver injury and fibrosis after CCl4 administration. The degradation of cytochrome P450 2E1 (CYP2E1), the major enzyme involved in metabolism of CCl4 whose products in excess result in liver injury, was delayed in the FGFR4-deficient mice after CCl4 treatment. These data are a second example of how pericellular matrix-linked FGFR4 communicates the status of the extracellular environment to hepatocyte metabolic networks. They suggest an important role of hepatocyte FGFR4 in limitation of the extent of toxin product-induced liver injury and fibrosis and restoration of the hepatolobular architecture rather than cellularity. Materials and Methods Animals and Administration of CCl4 Disruption of the mouse fgfr4 locus was carried out in 129 Sv strain-derived ES cells as described. 7 Mice used in the study were limited to 7-to-8-week-old females. Mice were maintained in 12-hour light/12-hour dark cycles with free access to food and water. Three to five mice were used for each experimental group as described in the text. For acute CCl4-induced liver damage study, a single dose of 2.0 ml/kg of body weight (2:5 v/v in mineral oil) was administered by intraperitoneal (IP) injection. For chronic CCl4-induced liver damage study, a dose of 2.0 ml/kg of body weight of CCl4 was administered IP twice per week. Livers were excised for analysis after the mice were weighed, anesthetized, and exsanguinated. Neither FGFR4 (+/+) nor FGFR4 (−/−) mice exhibited overt symptoms or mortality from the single acute dose of CCl4. The chronic damage protocol resulted in a 10% mortality rate in both wild-type and mutant animals. All procedures were performed in accordance with the Institutional Animal Care and Use Committee at the Institute of Biosciences and Technology, Texas A&M University System Health Science Center. Enzyme Analyses Blood plasma levels of alanine transaminase (aminotransferase) (ALT) activity were measured using the GP-Transaminase kit (No. 505-P, Sigma, St. Louis, MO). Plasminogen activator activity was assessed by zymography. One hundred μg of total liver protein was subjected to 10% SDS-PAGE under non-reducing conditions. The acrylamide gel was washed for 30 minutes in 2.5% Triton X-100/PBS and for 30 minutes in distilled water and then placed on a casein gel containing 2% (w/v) nonfat dry milk, 1% (w/v) agarose, and 15 μg/ml plasminogen (Roche, Indianapolis, IN) in PBS, and incubated in a humid chamber at 37°C until caseinolytic bands were visible and then photographed. Protein kinase A (PKA) activity was measured using the SignalTECT cAMP-dependent protein kinase (PKA) assay system (No. V7480, Promega, Madison, WI). Hepatocyte DNA Synthesis Two hours before sacrifice of the animals for analysis, 50 μg per g body weight of bromodeoxyuridine (BrdU) was administered intraperitoneally. The livers were removed and weighed at the times indicated in the text. BrdU incorporation in fixed liver sections was visualized with an anti-BrdU monoclonal antibody (No. 2531, Sigma) and an alkaline phosphatase-conjugated second antibody. Positive hepatocytes were counted, and BrdU incorporation was expressed as the percentage of the number of labeled hepatocytes in four or five visual fields. Histological Analysis and Measurement of Collagen Liver tissues were fixed overnight in Histochoice Tissue Fixative MB (No. H120–4L, Amresco, Solon, OH), dehydrated through a series of ethanol treatments, and embedded in paraffin according to standard procedure. Sections were prepared and stained with hematoxylin and eosin and for collagen using Sirius Red (0.02%). Quantitative analysis of collagen in Sirius Red-stained liver sections was performed by morphometric analysis. Briefly, liver sections were stained with Sirius Red, and slides were computer analyzed to calculate the percentage of collagen in total liver tissue area using Scion Image Beta 4.0.2 (Scion Corporation, downloaded from www.scioncorp.com). mRNA Analysis by Northern Hybridization and RNase Protection Total RNA was isolated from livers with the Ultraspec RNA Isolation system (No. BL-10200, Biotecx Laboratories, Houston, TX), and specific mRNAs were measured by Northern blot hybridization. Briefly, about 20 μg of RNA was separated electrophoretically on 1% agarose gel containing 2.2 mol/L formaldehyde and transferred to BrightStar-Plus positively charged nylon membranes (No. 10104, Ambion, Austin, TX). The mouse cyp2e1 and β-actin cDNAs were labeled with P32 by random primer labeling method. The membrane was first hybridized with the cyp2e1 probe in ULTRAhyb ultrasensitive hybridization buffer (No. 8670, Ambion) overnight at 42°C, followed by washing and autoradiography. The amount of radiographical product was quantitated using a phosphorimager (Molecular Dynamics, Sunnyvale, CA). The same membrane was stripped of probe and then hybridized with the β-actin cDNA, followed by washing, autoradiography, and quantitation by the phosphoimager. Densitometric units between samples were normalized for RNA load by division of the density by the density of the internal β-actin in each sample. Experimental values were expressed in units relative to the level of expression in wild-type mice that was assigned a value of one as described in the text. For RNase protection, 50 μg of total liver RNA was hybridized with 1 × 105 cpm of [P32]-labeled specific mouse plasminogen or urokinase-type plasminogen activator (uPA) antisense riboprobes with β-actin riboprobes in the same reaction mixture. After treatment with ribonuclease, protected products were analyzed on 5% polyacrylamide sequencing gels, followed by autoradiography. Size of protection products was determined from the product of a DNA sequencing reaction parallel to the protection assays. The amount of each radiographical product was quantitated using a phosphorimager (Molecular Dynamics). Immunochemical Analysis by Western Blot For immunochemical analysis, livers were homogenized in PBS containing 0.5% sodium deoxycholate and 0.1% SDS and centrifuged. The protein concentration was determined using the BCA Protein Assay reagent (No. 23225X, Pierce, Rockford, IL). A total of 25 μg of protein was subjected to 12% SDS-PAGE, transferred to Hybond-P membrane (Amersham, Piscataway, NJ) which was incubated with 1:2000 dilution of rabbit anti-human CYP2E1 antiserum (a gift from Dr. Jerome M. Lasker, Mount Sinai School of Medicine), washed, and then incubated with 1:20,000 dilution of goat anti-rabbit IgG conjugated to horseradish peroxidase (Bio-Rad, Hercules, CA). Bands were visualized by development with the Amersham ECL-Plus detection reagents (Amersham) and quantitated using an AlphaImager (Alpha Innotech, San Leandro, CA). Experimental values were expressed in units relative to the level of expression in wild-type mice that was assigned a value of one as described in the text. Statistical Analyses Values were expressed as the mean ± SD from the number of replications described in the text. The statistical significance of differences between mean values (P < 0.05) was evaluated using the two-tailed Student’s t-test. Results Liver Injury after Acute CCl4 Administration Twelve hours after a single injection of CCl4, lytic liver damage monitored by blood plasma ALT levels in FGFR4 (−/−) mice was four times that of wild-type FGFR4 (+/+) mice (Figure 1A) ![]() ![]() ![]()
Visual inspection of the livers revealed non-transparent white punctate foci indicative of focal damage in FGFR4 (−/−) livers at 168 hours post-CCl4 treatment, while the appearance of untreated null mice and the treated livers in FGFR4 (+/+) mice were near normal (Figure 2A) ![]() ![]() ![]() ![]()
Abnormal Activation of Urokinase Type Plasminogen Activator in FGFR4-Deficient Mice after Acute CCl4 Administration Liver repair after a toxic injury requires restoration of cellularity coordinated with the timely proteolytic clearance of matrix components and necrotic cells. Mice deficient in plasminogen and uPA exhibit impaired hepatolobular restoration, and, thus, it has been proposed that both play key roles in the proteolytic clearance of matrix components and necrotic cells after acute CCl4-induced liver injury. 10,11 We determined whether the expression of either plasminogen or uPA was impaired in the FGFR4-deficient livers. Analysis of mRNA levels by ribonuclease protection (RPA) revealed that there was no difference in plasminogen mRNA expression after acute CCl4 administration (Figure 3A) ![]() ![]() ![]()
Liver Injury and Fibrosis after Chronic CCl4 Administration Both normal and FGFR4-deficient mice were administered 2.0 ml/kg of body weight of CCl4 twice per week. Examination of paraffin-embedded sections of livers after 3 weeks revealed extensive zone 3 injury which bridged from vein to vein in livers of the FGFR4 (−/−) mice. In contrast, livers from FGFR4 (+/+) mice exhibited mild injury (Figure 4A) ![]() ![]() ![]() ![]()
Absence of FGFR4 Delays Down-Regulation of Liver CYP2E1 Induced by CCl4 Since FGFR4 down-regulates cytochrome P450 enzyme, CYP7A, at the level of transcription to modulate liver bile acid synthesis from cholesterol, we investigated the impact of deletion of FGFR4 on CYP2E1. CYP2E1 is thought to be the key enzyme involved in metabolism of CCl4 whose bioactive products result in CCl4-induced liver injury. 12,13 Expression level and stability determine the extent of CCl4-induced liver injury. Ethanol potentiates CCl4-induced liver injury 14-16 by increasing the synthesis 17 and stabilization 18 of CYP2E1. α-hederin prevents CCl4-induced hepatoxicity by decreasing the expression and activity of the CYP2E1 enzyme. 19 Analysis of expression of the cyp2e1 gene at both the mRNA (Figure 5A) ![]() ![]() ![]() ![]()
Absence of FGFR4 Accelerated the Decrease in Protein Kinase A Activity in Liver after an Acute Dose of CCl4 Rapid degradation of CYP2E1 has been suggested to involve hormone-activation of cAMP-dependent protein kinase A, phosphorylation of CYP2E1, and phosphorylation- and ubiquitin-dependent degradation. 21-23 The FGF signaling system has been shown to activate PKA in other systems such as SK-N-MC cells 24 and NIH 3T3 cells. 25 We tested whether PKA activity was different between CCl4-treated wild-type and mutant mouse livers before the 4 to 8 hour window in which CYP2E1 was persistent in FGFR4-deficient mice. PKA activity increased slightly at 2 hours post-CCl4 treatment in the livers from both types of animals and peaked at 4 hours in the wild-type mice (Figure 6) ![]()
Discussion Here we show that hepatocyte FGFR4 plays an important role in the orderly restoration of liver mass and morphology independent of hepatocyte proliferation after both acute and chronic toxic insult to the liver. In the latter case, FGFR4 contributes to the limitation of resultant liver fibrosis. Mice devoid of FGFR4 display a delay in repair of zone 3 injury due to a one-time toxic dose of CCl4 and severe fibrotic damage caused by repeated exposure to the same agent. Metabolism of xenobiotics and other potentially insulting agents, such as CCl4, occurs predominantly in the pericentral zone (zone 3) of the liver where its products cause hepatocyte injury which can be of both short- and long-term consequences to the liver. 26-28 Energy metabolism is partitioned between the periportal zone (zone 1), where oxidative energy metabolism, glucose release, and amino acid utilization occur, and the pericentral zone (zone 3), where glucose uptake, ketogenesis, and diverse biotransformations, such as cholesterol metabolism and bile acid synthesis, occur in addition to xenobiotic and toxin metabolism. Previously, we showed that FGFR4-deficient mice exhibited elevated cholesterol metabolism and bile acid synthesis suggesting that FGFR4 signaling plays a role in the process predominantly through a dampening effect. 8 The effect of the FGFR4 deficiency was traced to elevated expression of the rate-limiting enzyme in the conversion, CYP7A, at the mRNA level that was not repressed by dietary cholesterol. Here we show that the absence of FGFR4 provides a 4 or more hour delay in degradation of CYP2E1, the rate-limiting step in the detoxification of CCl4 that results in hepatocyte-damaging by-products as a consequence of the conversion. Thus, the control of damage by FGFR4 signaling may be due, in part, to its delay to the timetable for degradation of CYP2E1. In contrast to depression of CYP7A in cholesterol metabolism and bile acid synthesis at the mRNA level, FGFR4 appears to exert its effect on CYP2E1 at the protein level. Our results suggest that FGFR4 may sustain PKA activity sufficiently to prevent prolonged stability and activity of CYP2E1 in damaged livers. Further work is needed to link FGFR4 signaling to phosphorylation of CYP2E1 by PKA. The fact that both bile acid synthesis and CCl4 transformation occur in zone 3 hepatocytes and both are modulated by FGFR4 suggests that FGFR4 may play an important role in signaling external perturbation to potentially damaging metabolic networks, particularly in zone 3 hepatocytes. FGFR4 (−/−) hepatocytes may be more sensitive to damage that causes accelerated DNA synthesis and proliferation of hepatocytes; however, the FGFR4 (−/−) livers exhibited areas filled with debris and inflammatory cells at 168 hours post-CCl4 well after cellularity was restored. The latter phenotype was similar to mice devoid of plasminogen and plasminogen activators that had no evidence of increased sensitivity to the same CCl4 insult. 10,11,29,30 Similar to FGFR4 (−/−) mice, 8 hepatocellular proliferation was not impaired and liver size increased out of proportion to body weight independent of an increase in cell number. 11 This indicated a role of plasminogen and uPA-mediated processes similar to hepatocyte FGFR4 in hepatolobular restoration independent of cell proliferation. FGF signaling impacts plasminogen activator activity in a positive mode coincident with cell proliferation or tissue remodeling in a number of different experimental systems. These include remodeling of the vasculature in angiogenesis, 31 germinal vesicle breakdown in ovarian follicles, 32 and myoblast migration and fusion. 33 In the latter, FGF2 down-regulates uPA expression coincident with delay of myoblast fusion in differentiating myoblasts. Surprisingly, the FGFR4 (−/−) mice exhibited a constitutively elevated level of uPA beginning at 72 hours post-CCl4 insult suggesting that FGFR4 signaling may normally down-regulate uPA in damaged livers. These results clearly show that the FGFR4 (−/−) phenotype is not a consequence of deficient plasminogen/plasminogen activator activity. Whether FGFR4 signaling is downstream of and up-regulated by uPA, and down-regulates uPA activity in feedback mode, eg, deficient FGFR4 signaling mediates the phenotype caused by deficient plasminogen/plasminogen activator, is a subject of future study. Likewise, it is of interest to know whether chronic uPA activity eventually contributes to the delay of normal hepatolobular restoration. It has become increasingly clear that the ubiquitous and extremely diverse members of the FGF family of activating FGF polypeptides, FGFR transmembrane kinases, and heparan sulfate oligosaccharide chains combine in a tissue-specific mode to sense perturbation and maintain homeostasis, both in diverse developing and adult tissues. 4,6,34 The FGFR4 complex, the specific isotype of the four FGFR kinases present in mature hepatocytes, 4,6 is in a strategic position to monitor homeostasis and perturbation of the perilobular liver environment through its matrix-associated heparan sulfate subunit and matrix-controlled activating FGF ligands. 4 Our results suggest a dual role of hepatocyte FGFR4, both in limitation of the product-induced damage during biochemical detoxification and the reconstitution of normal architecture occurring as a consequence of toxic insult. Modulation of hepatocyte FGFR4 signaling may be a useful target for therapeutic modulation of toxin-induced liver injury and fibrosis and the FGFR4-deficient mice a useful model for study of both high-level acute and low-level chronic liver insult, including cirrhosis. Acknowledgments We thank Dr. Jerome M. Lasker (Mount Sinai School of Medicine) for the rabbit anti-human CYP2E1 antiserum. Footnotes Address reprint requests to Wallace L. McKeehan, Institute of Biosciences and Technology, Texas A&M University System Health Science Center, 2121 W. Holcombe Blvd., Houston, TX 77030-3303. E-mail: wmckeeha/at/ibt.tamu.edu. Supported by Public Health Service Grants DK35310 and DK47039 from National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) at the National Institutes of Health. References 1. Berlanga J, Caballero ME, Ramirez D, Torres A, Valenzuela C, Lodos J, Playford RJ: Epidermal growth factor protects against carbon tetrachloride-induced hepatic injury. 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Johansson I, Eliasson E, Ingelman-Sundberg M: Hormone controlled phosphorylation and degradation of CYP2B1 and CYP2E1 in isolated rat hepatocytes. Biochem Biophys Res Commun 1991, 174:37-42 [PubMed] 23. Tierney DJ, Haas AL, Koop DR: Degradation of cytochrome P450 2E1: selective loss after labilization of the enzyme. Arch Biochem Biophys 1992, 293:9-16 [PubMed] 24. Hansen TV, Rehfeld JF, Nielsen FC: Mitogen-activated protein kinase and protein kinase A signaling pathways stimulate cholecystokinin transcription via activation of cyclic adenosine 3′, 5′-monophosphate response element-binding protein. Mol Endocrinol 1999, 13:466-475 [PubMed] 25. Pursiheimo JP, Jalkanen M, Tasken K, Jaakkola P: Involvement of protein kinase A in fibroblast growth factor-2-activated transcription. Proc Natl Acad Sci USA 2000, 97:168-173 [PubMed] 26. Gumucio J, Chianale J: Liver cell heterogeneity and liver function. Arias I Jacoby W Popper H Schachter D Schafritz D eds. 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Clin Sci (Lond). 1998 Mar; 94(3):219-23.
[Clin Sci (Lond). 1998]Biochem Biophys Res Commun. 1996 Jan 5; 218(1):1-5.
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[Hepatology. 2000]Prog Nucleic Acid Res Mol Biol. 1998; 59():135-76.
[Prog Nucleic Acid Res Mol Biol. 1998]Prog Nucleic Acid Res Mol Biol. 1998; 59():135-76.
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[Proc Natl Acad Sci U S A. 1999]Am J Pathol. 2001 Mar; 158(3):921-9.
[Am J Pathol. 2001]Pharmacol Ther. 1989; 43(1):139-54.
[Pharmacol Ther. 1989]Toxicol Appl Pharmacol. 1998 Nov; 153(1):109-18.
[Toxicol Appl Pharmacol. 1998]Gastroenterology. 1974 Mar; 66(3):415-22.
[Gastroenterology. 1974]Toxicology. 1978 Jul; 10(3):261-70.
[Toxicology. 1978]Toxicol Appl Pharmacol. 1997 Jan; 142(1):13-21.
[Toxicol Appl Pharmacol. 1997]Proc Natl Acad Sci U S A. 1990 Apr; 87(8):3225-9.
[Proc Natl Acad Sci U S A. 1990]Biochem Biophys Res Commun. 1991 Jan 15; 174(1):37-42.
[Biochem Biophys Res Commun. 1991]Arch Biochem Biophys. 1992 Feb 14; 293(1):9-16.
[Arch Biochem Biophys. 1992]Mol Endocrinol. 1999 Mar; 13(3):466-75.
[Mol Endocrinol. 1999]Proc Natl Acad Sci U S A. 2000 Jan 4; 97(1):168-73.
[Proc Natl Acad Sci U S A. 2000]Hepatology. 1982 May-Jun; 2(3):385-95.
[Hepatology. 1982]J Biol Chem. 2000 May 19; 275(20):15482-9.
[J Biol Chem. 2000]Proc Natl Acad Sci U S A. 1999 Dec 21; 96(26):15143-8.
[Proc Natl Acad Sci U S A. 1999]Am J Pathol. 2001 Mar; 158(3):921-9.
[Am J Pathol. 2001]J Hepatol. 2001 Dec; 35(6):781-9.
[J Hepatol. 2001]Am J Pathol. 2001 Dec; 159(6):2179-86.
[Am J Pathol. 2001]J Biol Chem. 2000 May 19; 275(20):15482-9.
[J Biol Chem. 2000]Prog Nucleic Acid Res Mol Biol. 1998; 59():135-76.
[Prog Nucleic Acid Res Mol Biol. 1998]J Biol Chem. 1999 May 28; 274(22):15947-52.
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[Prog Nucleic Acid Res Mol Biol. 1998]J Biol Chem. 1999 May 28; 274(22):15947-52.
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