Journal.hep.com.cn
Protein Cell 2014, 5(2):113–123DOI 10.1007/s13238-013-0013-0
Signaling control of the constitutiveandrostane receptor (CAR)
Hui Yang, Hongbing Wang&
Department of Pharmaceutical Sciences, University of Maryland School of Pharmacy, 20 Penn Street, Baltimore, MD 21201,USA& Correspondence:
[email protected] (H. Wang)Received November 24, 2013
Accepted December 7, 2013
; Plant, Originally cloned as a constitutively
activated receptor without a clearly defined biological func-
The constitutive androstane receptor (CAR, NR1I3) plays
tion, the importance of CAR in xenobiotic metabolism was
a crucial role in the regulation of drug metabolism,
first appreciated when CAR was functionally linked to the
energy homeostasis, and cancer development through
long-known phenobarbital-mediated induction of hepatic
modulating the transcription of its numerous target
cytochrome P450 (CYP) 2B gene family (Honkakoski et al.,
genes. Different from prototypical nuclear receptors,
; Kawamoto et al., Encouraged by these find-
CAR can be activated by either direct ligand binding or
ings, numerous investigations have been carried out to
ligand-independent (indirect) mechanisms both initiated
explore the role of CAR in xenobiotic metabolism, detoxifi-
with nuclear translocation of CAR from the cytoplasm. In
cation, and clearance (Maglich et al., ; Tolson and
comparison to the well-defined ligand-based activation,
Wang, ). In humans, two functional enhancer modules,
indirect activation of CAR appears to be exclusively
namely the phenobarbital-responsive enhancer module
involved in the nuclear translocation through mecha-
(PBREM) and the xenobiotic-responsive enhancer module
nisms yet to be fully understood. Accumulating evi-
(XREM), have been identified upstream of the CYP2B6 gene
dence reveals that without activation, CAR forms a
and functionally characterized as the CAR binding sites in
protein complex in the cytoplasm where it can be func-
response to chemical stimuli (Honkakoski et al., Wang
tionally affected by multiple signaling pathways. In this
et al., CAR is also known to control the inductive
review, we discuss recent progresses in our under-
expression of other CYP enzymes such as CYP3A4
standing of the signaling regulation of CAR nuclear
(Goodwin et al., ), CYP2Cs (Ferguson et al.,
accumulation and activation. We expect that this review
Gerbal-Chaloin et al., ), CYP2A6 (Wortham et al.,
will also provide greater insight into the similarity and
), and to a lesser extent CYP1A1 and CYP1A2 (Yosh-
difference between the mechanisms of direct vs. indirect
inari et al., which contribute to the metabolism of
human CAR activation.
approximately 75% of clinically used drugs and the detoxi-fication of numerous environmental chemicals (Johansson
constitutive androstane receptor, nuclear
and Ingelman-Sundberg, ). Further studies have
translocation, phosphorylation, signaling regulation
extended CAR target genes including those encoding phaseII enzymes such as the uridine diphosphate glucuronosyl-transferase (UGT) isoforms (i.e., UGT1A1, UGT1A6, and
UGT1A9) (Sugatani et al., Osabe et al., ; Buckley
The constitutive androstane receptor (CAR), a member of
and Klaassen, glutathione S-transferases and sul-
the nuclear receptor superfamily (subfamily 1, group I,
fotransferases (Maglich et al., Yanagiba et al., ),
member 3 [NR1i3]), plays an important role in coordinating
as well as efflux and uptake drug transporters such as
cellular responses to the stimulation of both exogenous and
multidrug resistance-associated proteins (MRPs) (Cherring-
endogenous chemicals by regulating the expression of its
ton et al., ), multidrug resistance protein 1
target genes (Qatanani and Moore, Stanley et al.,
(MDR1) (Burk et al., ; Cerveny et al., ),
The Author(s) 2014. This article is published with open access at Springerlink.com and journal.hep.com.cn
Hui Yang and Hongbing Wang
and organic anion-transporting polypeptide 1 (OATP1) (Ding
illustrating an anti-cancer potential (Chakraborty et al.,
et al., Osabe et al., ). In addition to its broad
). Moreover, the enhanced cell proliferation by pheno-
spectrum of target genes, CAR also senses numerous
barbital in the liver of wild-type mice was completely abro-
xenobiotics and endobiotics as activators or deactivators
gated in the double-humanized CAR and pregnane X
receptor (PXR) mouse model (Ross et al., Although
metabolism, detoxification, and clearance in the liver. Up-
the underlying mechanisms of the significant species differ-
regulation of these drug-metabolizing enzymes or drug
ences of CAR in tumor development are largely unknown,
transporters by CAR activators may accelerate the bio-
such variances might be attributed to the divergent regula-
transformation of co-administered drugs, usually leading to
tion of differential genes governing DNA synthesis, cell
efficacy, enhanced toxicity, or
proliferation, apoptosis, and migration by hCAR vs. its rodent
increased bioactivation of prodrugs. For instance, recent
counterparts (Ross et al., Kamino et al., Tak-
studies in our lab have demonstrated that activation of CAR
izawa et al., Collectively, findings from these initial
can enhance the bioactivation of cyclophosphamide (CPA)
basic investigations hold the potential to advance CAR from
and facilitate CPA-based chemotherapeutic activity in leu-
a well-known xenobiotic sensor to an endobiotic modulator
kemia cells (Wang et al., ). Understanding the role of
that may eventually become a promising drug target for
CAR in mediating variable drug responsiveness and drug-
metabolic disorders as well as cancer therapy.
drug interactions has become an intense focus of both
Unlike PXR, the closest relative of CAR in the nuclear
academic and industrial research efforts and may lead to
receptor superfamily tree, CAR is constitutively activated in
enhanced prediction of drug-drug interactions and xenobi-
nearly all immortalized cells and spontaneously accumulated
in nuclei of these cells prior to chemical stimulated activation
Other than the well-established roles of CAR in the reg-
(Kawamoto et al., ). Moreover, CAR is featured as a
ulation of drug metabolism and transport, where it functions
nuclear receptor that could be transactivated through either
as a xenobiotic sensor, emerging evidence strongly sug-
the classical direct ligand binding or a mutedly defined
gests that CAR also modulates various hepatic functions that
ligand-independent indirect mechanism (Kawamoto et al.,
control diverse physiological and pathophysiological condi-
; Maglich et al., ). These characteristics make the
tions, including energy metabolism, insulin signaling, cell
studies of CAR activation extremely challenging and pose
proliferation, and tumor development (Fig. ). In mice,
major difficulties for evaluating drug-mediated CAR activa-
selective activation of CAR significantly alleviated high fat
tion in vitro. This review is aimed to highlight the recent
diet-induced obesity and type 2 diabetics via a combined
advances in our understanding of the molecular mecha-
inhibition of lipogenesis, fatty acid synthesis, and gluco-
nisms behind drug-mediated nuclear translocation and acti-
neogenesis, as well as the increase of energy expenditure in
vation of CAR, with a particular focus centered on signaling
brown adipose tissues (Dong et al., Gao et al.,
pathways that contribute to indirect activation of CAR.
Masuyama and Hiramatsu, Particularly, CAR influ-ences energy homeostasis by suppressing the expression of
ACTIVATION OF CAR
phosphoenolpyruvate carboxykinase (PEPCK), glucose-6-phosphatase (G6Pase) (Kachaylo et al., sterol regu-
As a so-called orphan receptor, CAR can be activated by a
latory element-binding protein 1c (Roth et al., ), acetyl-
broad array of xenobiotic chemicals, often at micromolar
CoA carboxylase 1, fatty acid synthase (FAS), and stearoyl-
concentrations, which differs from the classical steroid-hor-
CoA desaturase-1 (SCD-1) (Du et al., ). The essential
mone receptors which respond to endogenous ligands at
role of CAR in phenobarbital- and 1,4-bis[2-(3,5-dichloro-
nanomolar concentrations (Giguere, Tzameli and
pyridyloxy)] benzene (TCPOBOP)-induced tumor promotion
Moore, ). Structurally, however, CAR shares common
was initially established by using CAR knockout and wild-
functional features with other typical nuclear receptors,
type mice (Yamamoto et al., Huang et al., In
including a highly variable N-terminal AF1 domain, a DNA
this regard, the known tumor promoters stimulated cancer
binding domain (DBD), a ligand-binding domain (LBD), and a
progression by a CAR-dependent perturbation of the
C-terminal AF2 domain. The highly conserved DBD contains
expression of the growth arrest and DNA damage-inducible
unique structures that can recognize and bind to specific
45 beta (GADD45B) (Columbano et al., ), the murine
promoter regions in target genes, namely xenobiotic
double minute 2 (mdm2) (Huang et al., as well as the
response elements such as the aforementioned PBREM and
newly identified tubulin alpha 8 (TUBA8) (Kamino et al.,
XREM in the CYP2B6 promoter. Response elements binding
In contrast to these observed roles of murine CAR in
to CAR are usually composed of two direct repeats of the
tumor development, activation of human (h) CAR by the
consensus hexametric sequence of AG(G/T)TCA spaced by
three to four nucleotides (i.e., DR3 or DR4) (Makinen et al.,
). In the nucleus, CAR only binds to its response ele-
CO), appears to be associated with cell cycle arrest and
ments after forming heterodimers with the retinoid X receptor
enhanced apoptosis in human brain tumor stem cells,
(RXR). The X-ray crystal structure of the hCAR/RXR LBDs
The Author(s) 2014. This article is published with open access at Springerlink.com and journal.hep.com.cn
Signaling control of CAR
PhaseI/II enzymes
Drug transporters
(SREBP, ACC, FAS)
Cell proliferation
Figure 1. Schematic illustration of biological functions of CAR. The size of hollow arrows indicates the abundance of available
evidence for each function of CAR. Up and down black arrows symbolize increased and decreased gene expression, respectively.
reveals that CAR contains a single-turn Helix X that restricts
that TCPOBOP dose-dependently restores mCAR activity
the conformational freedom of the C-terminal AF2, and a
following inhibition by the inverse agonists (Tzameli et al.,
relatively small ligand binding pocket (Xu et al., ). Such
). Notably, mutation of key residues inside the mCAR
features permit CAR to interact with co-activator proteins and
ligand-binding pocket entirely eliminated the stimulatory
maintain a constitutively activated status once translocated
effect of TCPOBOP, as well as the inhibitory effect of an-
into the nucleus. Importantly, although CAR shares several
drostanes, without affecting the constitutive activity of CAR
common characteristics with classical nuclear receptors,
(Tzameli et al., ). These results clearly establish CAR
increasing evidence suggests that CAR can be activated by
as a xenobiotic responsive modular protein that can be
both direct ligand-binding and ligand-independent mecha-
activated/deactivated by binding with agonistic and antago-
nisms (Kawamoto et al., Maglich et al., ). To this
nistic ligands, respectively.
end, it appears that CAR activation is a multi-step process
Importantly, CAR exhibits remarkable species selectivity
and most identified CAR activators may not directly bind to
in its ligand binding and activation profiles, which makes
the receptor.
direct extrapolation of findings from mouse to human extre-mely risky. For example, TCPOBOP and estradiol activatemouse but not human CAR, and pharmacological concen-
Direct activation
trations of androstanol, progesterone, and testosterone
Owing to the constitutive activation of CAR, the initial search
repress mouse but not human CAR (Handschin and Meyer,
for CAR ligands has resulted with the identification of andr-
; Maglich et al., The first selective hCAR agonist,
ostenol and androstanol as inverse-agonists of CAR (For-
the imidazothiazole derivative-CITCO, came through a
man et al., Mechanistically, these androstanes
combination of in vitro and cell-based screening in 2003
convert CAR from constitutive to basal activity by disrupting
(Maglich et al., ). CITCO selectively binds to hCAR and
the salt bridge that locks the H12 helix in its active confor-
activates CAR target genes in human primary hepatocytes
mation, promoting co-activator release from the LBD without
(Maglich et al., ; Ferguson et al., ; Faucette et al.,
interfering CAR/RXR dimerization or DNA binding (Shan
). Recent evidence also reveals that CITCO can effi-
et al., Subsequent studies uncovered TCPOBOP, the
ciently enhance recruitment of co-activators to the LBD of
most potent known member of the phenobarbital-like class of
hCAR by competing with antagonists such as PK11195 (Li
CYP2B inducers, as the first agonist of mouse (m) CAR, in
et al., and metformin (Yang et al., However,
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Hui Yang and Hongbing Wang
CITCO only moderately enhances the constitutively acti-
major breakthrough came with the identification of the con-
vated hCAR (less than 2-fold), compared with that of
served threonine (Thr)-38 of human CAR as the primary
TCPOBOP for mCAR (5- to 10-fold) in cell-based luciferase
residue that governs nuclear translocation and activation of
reporter assays (Tzameli et al., ; Maglich et al.,
CAR (Mutoh et al., Dephosphorylation of the Thr-38
Moreover, CITCO also activates human PXR and induces
appears to be essential for CAR translocation regardless of
PXR target genes at higher concentrations, leaving direct
exposure to direct or indirect activators (Mutoh et al., ).
comparison of human CAR and PXR target genes yet
The exact molecular mechanisms controlling Thr-38 CAR
challenging (Maglich et al., ). To date, there is no pure
hCAR agonist reported. Other chemicals exhibiting agonistic
understood. However, several kinase signaling pathways
effects on hCAR such as the antimalarial artemisinin, the
have recently been suggested to be important in the phos-
psychoactive diazepam and the anti-fungal myclobutani, are
phorylation of CAR.
also associated with potent activation of hPXR (Burk et al.,Li et al., ). Overall, ligand-dependent direct
Protein phosphatase 2A (PP2A)
activation of CAR may still rely on its initial step of translo-
The role of protein kinase-based signaling pathways in
cating CAR into the nucleus. Once inside the nucleus, CIT-
controlling phenobarbital-mediated induction of CYP450s
CO bound hCAR adopts a conformation similar to the
had been proposed, even before CAR was recognized as
constitutively active apo-CAR and maintains the intrinsically
the fundamental target of phenobarbital. Early studies
high consititutive activity.
showed that both activation of protein kinase A (PKA) by
elevated intracellular cyclic adenosine monophosphate
Indirect activation
(cAMP) and the inhibition of protein phosphatases PP1 and
The hallmark feature that differentiates CAR from classical
PP2A by okadaic acid (OA) resulted in complete repression
nuclear receptors lies in its ligand-independent nuclear
of phenobarbital-inducible CYP gene transactivation in pri-
accumulation and constitutive activation once expressed
mary rat hepatocytes (Sidhu and Omiecinski, ).
inside the nucleus of cells. To date, numerous CAR activa-
Although the transcription factor(s) that drive the phenobar-
tors have been identified, including clinically used drugs,
bital induction event was/were yet to be determined, these
environmental chemicals, and endogenous steroid metabo-
results indicated that both PKA and protein phosphatase
lites (Qatanani and Moore, Li and Wang, Molnar
pathways exert marked roles in modulating the signaling of
et al., Most of these activators however do not bind
phenobarbital-mediated CYP induction. After establishing
directly to CAR; instead activating CAR by stimulating its
CAR as the critical DNA-binding protein required for phe-
nuclear translocation in a ligand-independent manner (Li
nobarbital response, Negishi and colleagues demonstrated
et al., For example, the typical CYP2B inducer and
that OA pretreatment was sufficient to inhibit phenobarbital-
CAR activator phenobarbital does not bind directly to CAR
mediated nuclear translocation of CAR and induction of
but induces CAR transcriptional activition exclusively via
Cyp2b10 in primary mouse hepatocytes, suggesting that
nuclear translocation (Kawamoto et al., Moore et al.,
CAR nuclear accumulation is most likely regulated by a
). Notably, constitutive activation of CAR is not always a
dephosphorylation-sensitive signaling cascade (Kawamoto
beneficial feature. In this regard, CAR activation can
et al., Further studies from the same research group
enhance the metabolism and toxicity of some drugs, such as
revealed that CAR exists as a complex with Hsp90 in the
acetaminophen (Zhang et al., ), and potentially increase
cytoplasm of non-induced mouse liver hepatocytes. More
tumor propensity by stimulating cell proliferation (Takizawa
importantly, phenobarbital treatment recruited PP2A to the
et al., ). To accommodate such potential adversity, CAR
protein complex, which led to the dephosphorylation of CAR
is primarily located in the cytoplasm prior to activation in
(Yoshinari et al., ).
primary hepatocytes and intact liver in vivo (Kawamoto et al.,
Realizing the importance of phosphorylation/depho-
; Li et al., ). In this native hepatocyte environment,
sphorylation in CAR nuclear translocation and activation, the
CAR is spontaneously sequestered in the cytoplasm as a
next significant question to be answered was which amino
multi-protein complex including the heat shock protein 90
acid residue(s) is/are responsible for such chemical-stimu-
(Hsp90), cytoplasmic CAR retention protein, protein phos-
lated signaling. Serial-deletion and site-directed mutagene-
phatase 1 regulatory subunit 16A, and potentially other yet
sis of CAR led to the identification of a leucine-rich motif
unidentified proteins (Kobayashi et al., ; Yoshinari et al.,
(LXXLXXL) close to the C-terminal region, namely the
; Sueyoshi et al., Upon the stimulation of phe-
xenobiotic response sequence (XRS), as the potential
nobarbital-type indirect activators or CITCO/TCPOBOP-like
functional unit which dictates the nuclear translocation of
direct ligand-binding, CAR disassociates from the cytoplas-
CAR in response to various phenobarbital-type inducers
mic localized protein complex and moves into the nucleus. It
(Zelko et al., Xia and Kemper, ). Nevertheless,
was believed that this process is regulated by protein kinase-
these residues were not direct targets of either PP2A or
mediated phosphorylation/dephosphorylation of CAR. A
PKA. A real breakthrough in this regard came with the
The Author(s) 2014. This article is published with open access at Springerlink.com and journal.hep.com.cn
Signaling control of CAR
diligent work by Mutoh et al. in 2009, in which the Thr-38
phenobarbital-mediated induction of CYP2B1 was stimu-
residue of hCAR was established as the primary determinant
lated in the liver of diabetic rats where p38 MAPK was
for chemical-mediated phosphorylation/ dephosphorylation
activated by the disease itself (Yoshida et al., while
of CAR, while dephosphorylation of Thr-38 is a prerequisite
CYP induction by phenobarbital was attenuated in tumor-
for CAR translocation into the nucleus (Mutoh et al.,
bearing rats where p38 MAPK was down-regulated (Nu-
Consistent with earlier observations, treatment with OA
mazawa et al., Nonetheless, a definite role of p38
increased the phosphorylation of CAR at Thr-38 and
MAPK in CAR activation has yet to be established, given that
sequestered CAR in the cytoplasm of mouse primary
activation of p38 MAPK appears to enhance some but not all
hepatocytes (Mutoh et al., ).
target genes of hCAR.
Epidermal growth factor receptor (EGFR)
Extracellular signal-regulated kinase (ERK) and p38mitogen-activated protein kinase (MAPK)
Previous studies have shown that phenobarbital-inducedCYP2B gene transactivation could be effectively repressed
Accumulating evidence has demonstrated that expression of
by growth factors, such as EGF and insulin-like growth factor
various CYP enzymes was significantly repressed during
(IGF) (Bauer et al., Kietzmann et al., ; Thasler
liver regeneration, infection or inflammation, suggesting
et al., ). EGFR is a member of the ErbB family of
cellular signaling molecules such as growth hormones and
receptors that coordinates extracellular signals, such as
cytokines may play a role in the expression of xenobiotic-
EGF, to cellular signaling cascades and eventually promotes
metabolizing CYPs (Bauer et al., Koike et al., ). In
cell proliferation (Di Fiore et al., Recent studies by
particular, two independent studies provided strong evidence
Mutoh et al., identified EGFR as a phenobarbital-responsive
to show that phenobarbital-dependent activation of the rat
receptor that mediates CAR dephosphorylation and activa-
CYP2B1 promoter was repressed by the presence of epi-
tion in mouse primary hepatocytes (Mutoh et al., As
dermal growth factor (EGF) but promoted by U0126, a
shown in this study, phenobarbital antagonizes EGF-stimu-
known inhibitor of the MEK-ERK signaling pathway (Bauer
lated EGFR phosphorylation and activation; abrogation of
et al., Joannard et al., ). Encouraged by these
EGFR signaling further induces the dephosphorylation of the
observations, Negishi and coworkers provided further
downstream receptor for activated C kinase 1 (RACK1) at
mechanistic evidence suggesting ERK is an endogenous
the residue of Tyr-52. The dephosphorylated RACK1 then
signal, regulating CAR phosphorylation and nuclear trans-
directly recruits PP2A to the cytosol localized CAR protein
location, by which U0126-mediated Cyp2b10 induction via
complex, where it dephosphorylates and releases CAR into
ERK1/2 deactivation was completely abrogated in CAR
the nucleus (Fig. More importantly, this study provides the
knockout mice (Koike et al., Moreover, co-immuno-
first evidence that phenobarbital can directly bind to EGFR at
precipitation experiments revealed that activated ERK1/2 co-
pharmacologically relevant concentrations. Given that phe-
precipitated only with the Thr-38 phosphorylated CAR,
nobarbital is often referred to as an "orphan compound"
where the C-terminal located XRS appears to be essential
without a known direct target, EGFR may represent one of
for this interaction (Osabe and Negishi, This interac-
the molecular targets that initiates phenobarbital-mediated
tion was significantly increased after EGF exposure while
cellular responses, including CAR activation. On the other
treatment with U0126 decreased the level of CAR phos-
hand, phenobarbital may not function as a prototypical
phorylation at Thr-38 and eventually released CAR into the
EGFR inhibitor, such as gefitinib and erlotinib, which can
nucleus (Osabe and Negishi, ).
antagonize EGFR-mediated cell proliferation and tumor
An outstanding phenomenon observed was that ectopic
development (Nakajima et al., ; Shin et al., ). In
expression of hCAR in HepG2 cells does not convey optimal
fact, phenobarbital itself is a potent tumor promoter in rodent
induction of CYP2B6 compared to what was observed in
animals via a CAR-dependent mechanism (Huang et al.,
human primary hepatocytes; many other cellular signals
; Yamamoto et al., ). Therefore, it is reasonable to
have been shown to regulate the activation of CAR.
speculate that phenobarbital might be an atypical antagonist
Recently, the p38 MAPK was identified as a required factor
of EGFR, which only selectively inhibits certain downstream
optimizing CAR activation and CYP2B6 induction in liver
events of EGFR signaling.
cells (Saito et al., ). In human primary hepatocytes, p38MAPK is highly activated, which significantly differs from that
AMP activated protein kinase (AMPK)
in human hepatoma cell lines, including HepG2 cells. Acti-vation of p38 MAPK by anisomycin robustly potentiated
AMPK is an enzyme that functions as an energy sensor by
induction of CYP2B6 mRNA by CAR activators in HepG2
regulating cellular energy metabolism and homeostasis.
cells to levels that were comparable to what was observed in
AMPK plays an important role in fatty acid oxidation, glucose
ligand-treated human primary hepatocytes. The potential
uptake, and hepatic lipogenesis by reacting to the fluctuation
significance of p38 MAPK in chemical-elicited CAR activa-
of the cellular AMP:ATP ratio (Hardie et al., Inoki et al.,
tion was also indirectly supported by the facts that
). Recent studies suggested that AMPK is involved in
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Hui Yang and Hongbing Wang
Collectively, these studies implicate rather contradictory
outcomes when connecting CYP2B transactivation and CAR
nuclear translocation to AMPK activation. Some of the dis-putes however, can be explained at least in part by the
diverse physiological properties of different species or cell
systems used in these studies, such as immortalized celllines vs. primary hepatocytes, human cells vs. rodent cells,and in vivo vs. in vitro. In addition, energy status and nutri-tional environment of the cells can also influence pheno-
barbital regulation of the CYP2B gene (Yoshida et al.,
Figure 2. Antagonistic effect of phenobarbital on EGFR
Rencurel et al.,
signaling and CAR activation. Arrows indicate activation and
the blunt arrow represents deactivation. (This figure was
Transcriptional regulation of CAR
adopted from Mutoh et al., Science Signaling).
Although the biological function of CAR relies predominantly
CAR-regulated CYP2B gene induction by phenobarbital-
on chemical-mediated activation/deactivation through direct
type inducers, but the precise role of AMPK in the activation
or indirect mechanisms, the expression level of CAR in
of CAR remains controversial. Studies from Meyer and col-
response to endogenous signals or xenobiotic chemicals
leagues showed that AMPK activator 5-AMINO-1-β-Dffff-
may also influence the downstream regulation of its target
ribofuranosyl-imidazole-4-carboxamide (AICAR), or expres-
genes. It is well known that dramatic interindividual differ-
sion of a constitutively active form of AMPK, mimicked
ences exist in the expression of hepatic CYP2B6, the pro-
phenobarbital-mediated induction of CYP2B6 in hepatoma
totypical target gene of hCAR (Wang and Tompkins, ).
cell lines (Rencurel et al., On the other hand, liver-
Nevertheless, the molecular mechanism(s) underlying this
specific deletion of AMPK catalytic subunits in mice impaired
large variability remains elusive. In comparison of a panel of
the inductive expression of Cyp2b10 and Cyp3a11, but did
12 individual human liver samples, Chang et al. revealed that
not inhibit the nuclear accumulation of CAR induced by
substantial interindividual differences of hCAR expression in
phenobarbital (Rencurel et al., ). Therefore, the authors
these samples were significantly and positively correlated
presumed the existence of another control step of CAR
with that of CYP2B6, indicating the abundance of this tran-
signaling independent of translocation. However, an in vivo
scription factor may contribute to the varied expression of the
study conversely showed that AICAR and metformin induced
CYP2B6 gene in human liver (Chang et al., ). Other
CAR nuclear translocation but failed to induce hepatic
studies highlighted that different from cognate CAR activa-
CYP2B genes in mice and rats, suggesting AMPK activation
tion, expression of CAR can be induced by a number of
is not sufficient for CYP2B induction (Shindo et al.,
xenobiotics including the glucocorticoid receptor agonist
In another study, AICAR was shown to prevent nuclear
(dexamethasone) (Pascussi et al., and peroxisome
translocation of CAR and repress phenobarbital-induced
CYP2B expression in rat primary hepatocytes (Kanno et al.,
(WY14643 and ciprofibrate) (Saito et al., ). In silico
). In the same study, metformin and the constitutively
analysis of the human CAR 5′-regulatory region led to the
active form of AMPK, however, enhanced PBREM-driven
identification of a putative glucocorticoid responsive element
transactivation by phenobarbital, suggesting AICAR inhibits
located between -4477 and -4410 base pair (Pascussi et al.,
CAR translocation in an AMPK-independent manner. Most
), a functional PPAR-alpha responsive element around
recently, we have shown that metformin dramatically
-4400 base pair, as well as a conserved hepatocyte nuclear
repressed phenobarbital/CITCO-induced CYP2B6 expres-
factor 4 alpha (HNF4α) binding site from upstream of the
sion through inhibiting dephosphorylation and nuclear
transcriptional start site (Ding et al.,
translocation of CAR (Yang et al., Consistent with this
Previous animal studies have demonstrated that fasting
observation, our data also demonstrated that AICAR mim-
and caloric restriction increase the expression and activity
icked the effect of metformin on CYP2B6 suppression, and
of CAR which in turn coordinates an adaptive response by
such repression was partially but concentration-dependently
slowing down the energy expenditure. CAR knockout ani-
restored by co-treatment with compound C (6-[4-(2-piperidin-
mals were unable to couple the metabolic adjustment and
lost more weight (Maglich et al., Qatanani et al.,
dine, a known inhibitor of AMPK. Although sequence align-
). Given that fasting typically increases the plasma
ments of the conserved Thr-38 region of CAR revealed no
level of free fatty acids that are natural ligands of PPARα,
consensus AMPK site, signaling molecules downstream of
and elevated interaction between PGC-1α and HNF4α is a
the AMPK pathway such as PKC (He et al., ) may
hallmark of fasting adaptation, functionally establishing CAR
function as the switch controlling CAR phosphorylation and
as a target gene of PPARα and HNF4α provides a novel
its disassociation from the retaining protein complex.
mechanistic model for CAR in energy homeostasis (Ding
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Signaling control of CAR
EGF, Phenobarbital
Figure 3. Signaling control of CAR activation. Chemicals illustrating activation or deactivation of a signaling pathway are denoted
in blue and red, respectively.
et al., ). Additional evidence indicated that stress-acti-
transcription of genes associated with drug metabolism and
vated protein kinase and ERK signaling pathways are also
transport, energy homeostasis, and cell proliferation. Our
associated with altered expression of CAR under serum-
understanding of the role of CAR in gene regulation as well as
starvation stress (Osabe et al., Most recently, our
the mechanisms of its activation has increased remarkably
own data have unexpectedly revealed that an insulin-like
during the past 15 years. As summarized in this review, an
growth factor-1 receptor (IGF-1R) inhibitor (BMS-665351)
astonishing number of cellular factors and foreign compounds
significantly induced the expression of CYP3A4 in human
intertwine in the regulation of CAR biological functions.
primary hepatocytes without activation of either CAR or
Although CAR shares several common features with its sister
PXR, instead it selectively induced the expression of CAR
receptor PXR, where they overlap in a number of target genes
(Li et al., ). Intriguingly, BMS-665351 did not activate
and xenobiotic activators, the mechanisms of CAR activation
either glucocorticoid receptor or PPARα at concentrations
have been proven to be relatively unique. To date, mounting
that induced the expression of CYP3A4 and CAR, implying
evidence demonstrates that CAR can be activated through
additional, yet unknown mechanisms may be involved in the
both classical ligand binding and ligand-independent mech-
transcriptional regulation of CAR. Collectively, in compari-
anisms, with indirect activation appearing to be predominant.
son with the heightened focus on the activation and deac-
Seminal works by Negishi and colleagues have shown that
tivation of CAR, much less is known regarding how the
the phosphorylation status of CAR is pivotal for its cellular
expression of CAR itself is controlled under the challenge of
localization and activation, which could be influenced by many
both endogenous and xenobiotic chemicals. Clearly, tran-
protein kinase signals (Mutoh et al., ). In the meantime,
scriptional regulation of the regulator would represent
the cellular expression of CAR itself appears to be affected by
another layer of CAR biology.
certain signaling molecules. Together, these data indicate thatCAR may represent a cell signaling-regulated nuclearreceptor rather than a typical ligand-dependent nuclear
CONCLUDING REMARKS
receptor (Fig. ). Given that CAR can be activated both
It is evident now that CAR has evolved into a sensor of both
directly and indirectly, it is essential to keep in mind that the
xenobiotic and endobiotic chemicals by governing the
ligand binding and kinase signaling may interconnect to
The Author(s) 2014. This article is published with open access at Springerlink.com and journal.hep.com.cn
Hui Yang and Hongbing Wang
achieve the optimal activation of this receptor. Undoubtedly,
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of the manuscript. We apologize to the scientists who made contri-
constitutive androstane receptor and pregnane X receptor path-
butions to the field, but have not been cited due to space limitations.
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This work was supported by NIH grants DK061652 and GM107058.
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T xas Node Newsletter Trivedi's Thoughts Dear Texas Node, This is the time where we all have undoubtedly reflected upon our accomplishments of the past year and are now in the midst of working Volume 2, Issue 1 toward our goals for this year. I'd like to take this opportunity to provide a ‘State of the Node' update. Last year was eventful and productive on many fronts. Study
MINISTERIO DE LA PRESIDENCIA DIRECCION ADMINISTRATIVA INFORME DE INGRESOS Y GASTOS FONDO PROGRAMA DEL DESPACHO SUPERIOR Del 1 de Julio de 2007 al 30 de Septiembre de 2007 Transferencias recibidas del Tesoro Nacional y otros Reembolso H.D. Jorge Alvarado 7894612 Depósito MEF No.7122110 Nota de crédito por reembolso de gastos médicos San Vicente de Paul de Colombia del el joven Gilberto Araúz por