Diabetes 51:1859-1866, 2002 © 2002 by the American Diabetes Association, Inc. Tanis: A Link Between Type 2 Diabetes and Inflammation?
1 Metabolic Research Unit, School of Health Sciences, Deakin University, Waurn Ponds, Victoria, Australia
Here we describe a novel protein, which we have named Tanis, that is implicated in type 2 diabetes and inflammation. In Psammomys obesus, a unique polygenic animal model of type 2 diabetes and the metabolic syndrome, Tanis is expressed in the liver in inverse proportion to circulating glucose (P = 0.010) and insulin levels (P = 0.004) and in direct proportion with plasma triglyceride concentrations (P = 0.007). Hepatic Tanis gene expression was markedly increased (3.1-fold) after a 24-h fast in diabetic but not in nondiabetic P. obesus. In addition, glucose inhibited Tanis gene expression in cultured hepatocytes (P = 0.006) as well as in several other cell types (P = 0.0010.011). Thus, Tanis seems to be regulated by glucose and is dysregulated in the diabetic state. Yeast-2 hybrid screening identified serum amyloid A (SAA), an acute-phase inflammatory response protein, as an interacting protein of Tanis, and this was confirmed by Biacore experiments. SAA and other acute-phase proteins have been the focus of recent attention as risk factors for cardiovascular disease, and we contend that Tanis and its interaction with SAA may provide a mechanistic link among type 2 diabetes, inflammation, and cardiovascular disease.
Elevated hepatic glucose output is an early pathological event in the development of type 2 diabetes (13) and may result primarily from increased rates of gluconeogenesis (4,5). Together with reduced clearance of glucose from the blood, increased hepatic glucose output is a significant contributor to the rise in blood glucose concentration, which is characteristic of type 2 diabetes. We hypothesized that the identification of genes that are differentially expressed in the liver of type 2 diabetic animals may provide new insights into hepatic metabolic pathways that contribute to type 2 diabetes and its complications. To test this, we conducted differential display PCR experiments using RNA obtained from the livers of fed and fasted Psammomys obesus (Israeli sand rats). P. obesus is a unique, polygenic animal model of type 2 diabetes and the metabolic syndrome (612). In their natural desert habitat, these animals remain lean and healthy on a low-energy diet of saltbush (Atriplex halimus) (6). However, when housed in a laboratory setting and given ad libitum access to standard rodent laboratory diet, a proportion of the animals develop a range of metabolic abnormalities, including insulin resistance, obesity, type 2 diabetes, and dyslipidemia (612). The distributions of body weight, blood glucose, and plasma insulin concentrations are continuous across the population of P. obesus (7,10) and closely approximate the distributions observed in human cross-sectional data (13,14). Previous studies of hepatic metabolism in P. obesus identified a number of factors that could contribute to hepatic insulin resistance in these animals. Compared with albino rats, P. obesus have low numbers of hepatocyte insulin receptors (15,16), increased gluconeogenesis and PEPCK activity (17), and elevated hepatic glucose output (18). Compared with their lean, nondiabetic littermates, P. obesus with type 2 diabetes have increased hepatic glucose output (18) and hepatic lipogenesis (17). Thus, hepatic metabolism in type 2 diabetic P. obesus exhibits a number of similarities with that observed in humans with type 2 diabetes.
Experimental animals. A colony of P. obesus is maintained at Deakin University (Geelong, Australia). Breeding pairs are fed a diet of lucerne and standard diet ad libitum. Experimental animals were weaned at 4 weeks of age and given a standard laboratory diet, from which 12% of energy was derived from fat, 63% from carbohydrate, and 25% from protein (Barastoc, Pakenham, Australia). Animals were housed in a temperature-controlled room (22 ± 1°C) with a 12-h light-dark cycle (light 06001800). Animals were classified as normal glucose tolerant (NGT), impaired glucose tolerant (IGT), or type 2 diabetic at 16 weeks of age according to their blood glucose and plasma insulin concentrations as previously described (7). Whole-blood glucose was measured using an enzymatic glucose analyzer (Model 27, Yellow Springs Instruments, Yellow Springs, OH). Plasma insulin concentrations were determined using a double-antibody solid-phase radioimmunoassay (Phadeseph, Kabi Pharmacia Diagnostics, Uppsala, Sweden).
Differential display PCR.
Sequencing.
Measurement of Tanis gene expression.
Cell culture.
Yeast-2 hybrid screen.
Expression and purification of recombinant Tanis and serum amyloid A proteins.
Surface plasmon resonance analysis.
Statistical analysis.
Differential display PCR was used to identify a gene whose expression was elevated in the liver of fasted P. obesus relative to fed controls (Fig. 1A). This band was excised and sequenced, revealing it to be a novel P. obesus gene with no apparent homologues in the public databases. We named this gene "Tanis, " a Hebrew word for fasting. Subsequently, several apparently homologous sequences have been submitted to Genbank (e.g., accession nos. AF157317 and AF335543). The entire P. obesus Tanis mRNA sequence, obtained using RACE, is shown in Fig. 1B. The predicted Tanis amino acid sequence is given in Fig. 1C, along with alignments to apparently homologous genes from other species. A high level of identity was evident between species (Table 1), indicative of a conserved gene with important physiological function.
P. obesus mRNA for Tanis consists of 1,155 nucleotides and encodes a protein of 189 amino acids. Sequence analysis of the predicted Tanis protein suggested a single transmembrane region (amino acids 2648), a dileucine motif, and a coiled-coil region.
Analysis using Expasy software tools (http://www.expasy.ch) predicted eight possible serine phosphorylation sites, one threonine phosphorylation site, three possible O-glycosylation sites, and four possible protein kinase C phosphorylation sites. Tanis could not be assigned to any known gene families and was predicted to have an overall composition of 44% The genomic structure of the P. obesus Tanis gene was determined by direct sequencing of gDNA and cDNA samples and is shown in Fig. 1D. The gene consists of six exons ranging in size from 76 to 660 nucleotides. Exon 6 includes coding sequence for the COOH-terminal 25 amino acids and 585 nucleotides of 3' untranslated region. The corresponding human gene, known as AD-015, was derived by automated computational analysis of genomic sequence at the National Center for Biotechnology Information (National Institutes of Health, Bethesda, MD) using gene prediction. The contig containing this sequence was localized to human chromosome 15q26.3 in the interval D15S157-qTEL, with the nearest marker identified as stSG26005. Of interest is that the syntenic chromosomal region in mice and pigs contains four obesity-related quantitative trait loci: Qw7 (19), Bw61 (20), Pfat1 (21), and SSC7 (22), suggesting that a gene in this region affects body fat accumulation. Hepatic Tanis gene expression was increased 2.2-fold after a 24-h fast in P. obesus (P < 0.001). Within the subgroups of animals, the increase in hepatic gene expression of Tanis after fasting was significant only in the diabetic animals (3.1-fold increase; P = 0.010) (Fig. 2). In ad libitumfed animals, expression of the Tanis gene in the liver was reduced in both IGT (P = 0.039) and type 2 diabetic P. obesus (P = 0.015) relative to their NGT littermates (Fig. 2). In addition, linear correlations were observed between Tanis expression and circulating triglyceride concentrations (Pearson r = 0.593, P = 0.007); (Fig. 3), as well as blood glucose (Spearman r = -0.378, P = 0.010) and insulin concentrations (Spearman r = -0.416, P = 0.004) in ad libitumfed P. obesus. There was also evidence of a correlation between hepatic Tanis gene expression and the change in blood glucose (Spearman r = 0.395, P = 0.010) and insulin concentrations (Pearson r = 0.374, P = 0.015) after 24 h of fasting. Multiple linear regression analysis indicated that only the change in blood glucose concentration was independently associated with Tanis gene expression (P = 0.004), suggesting a relationship between these two variables. In addition, when dietary energy restriction was continued for a period of 2 weeks (at 67% of normal dietary intake), Tanis gene expression in the liver was increased 2.2-fold relative to ad libitumfed control animals (1.91 ± 0.29 vs. 0.87 ± 0.08 arbitrary units, P = 0.006).
In accordance with the results obtained in vivo, cell culture experiments showed that Tanis gene expression in HepG2 hepatocytes was profoundly regulated by media glucose concentration (P = 0.006) (Fig. 4). Increasing the concentration of glucose in the media caused a dose-dependent reduction in the levels of Tanis gene expression, with a maximal effect observed at 12.5 mmol/l glucose of 90% suppression.
We tested for Tanis gene expression in tissues other than liver using both Taqman PCR and Northern blots. Tanis gene expression was detected by Taqman PCR in all tissues examined, including hypothalamus, liver, skeletal muscle, adipose tissue, testes, heart, and kidney. Northern blotting revealed a single band of the expected size (1,155 nucleotides) in a range of tissues, including liver, adipose tissue, hypothalamus, and skeletal muscle (Fig. 5).
Expression profiling of the Tanis gene in nonhepatic tissues revealed no effect of fasting on Tanis gene expression in adipose tissue, muscle, or hypothalamus (data not shown). However, in vitro Tanis gene expression was suppressed in a dose-dependent manner by glucose in 3T3-L1 adipocytes (Fig. 6) and C2C12 muscle cells (maximum effect of 50% suppression at 25 mmol/l glucose; P = 0.002). Tanis gene expression was also decreased by insulin in 3T3-L1 cells (Fig. 6) and in C2C12 cells (data not shown).
To examine further the physiological role of the Tanis protein, we conducted a yeast-2 hybrid screen to identify interacting proteins. Using Tanis as bait, 600,000 transformants from a human liver cDNA library were screened. Expression analysis of three different reporter genes independently confirmed four clones to be positive, with each showing evidence of interaction of intermediate strength. Sequencing of these clones revealed that three of the four encoded SAA, an acute-phase inflammatory response protein. The entire nucleotide sequence of all three positive clones identified in the yeast-2 hybrid screen matched with the known sequence of human SAA1ß, an allele of the SAA1 gene (Genbank accession no. CAA39974). The putative interaction between Tanis and SAA was confirmed by SPR analysis. A CM5 sensor chip with 4,737 RU of human plasma SAA coupled to its surface was initially used for testing interaction with GSTfull-length Tanis. The sensorgram revealed a binding phenomenon with GST-Tanis (data not shown). GSTfull-length Tanis, which contains the predicted transmembrane domain, was difficult to express and purify to a satisfactory degree. Therefore, we expressed and purified the COOH-terminal 136amino acid fragment of Tanis, which does not include the transmembrane region. The GST-Tanis-C protein was expressed and purified at satisfactory levels. In the SPR binding analysis, GST-Tanis-C demonstrated binding with human plasma SAA, which was concentration-dependent (Figs. 7A and B). Interaction was shown to be positive even in the reverse situation, where GST-Tanis was bound to the sensor chip as a ligand and SAA was passed through as an analyte (Fig. 7C).
SAA purified from human plasma is a heterogeneous sample likely to contain all of the forms of SAA present in circulating blood. To examine interactions with a homogeneous sample, we expressed and purified SAA1ß as a GST fusion protein and demonstrated its ability to interact with Tanis by SPR analysis (Fig 7D).
We have identified Tanis, a novel hepatic receptor for SAA that is regulated by glucose and differentially expressed in type 2 diabetes. Tanis therefore provides a potential link among diabetes, the acute inflammatory response, and cardiovascular disease. We searched specifically, using differential display PCR, for genes in the liver that exhibit an inappropriate response to fasting in diabetic P. obesus and identified the Tanis gene. Tanis is composed of six exons and five introns and encodes a cDNA product of 1,155 nucleotides. The human Tanis gene (AD-015) is located at 15q26.3. Although this region has not been previously identified in genome-wide linkage scans for diabetes-related phenotypes in human populations, the syntenic regions in mice and pigs contain several quantitative trait loci for phenotypes related to obesity (1922). The protein product of the Tanis gene is 189 amino acids in length and is predicted to have a single transmembrane region close to the NH2-terminus (amino acids 2648) (Fig. 1C), as well as numerous possible phosphorylation and glycosylation sites. The Tanis protein could not be assigned to any known families. The high degree of identity at both the nucleotide and amino acid levels for the Tanis gene (Table 1) indicate a high degree of conservation that suggests that Tanis is a protein of considerable physiological importance. Results from the differential display PCR suggested that hepatic expression of the Tanis gene in response to 24 h of fasting was dysregulated in P. obesus with type 2 diabetes (Fig. 1A). Profound changes in carbohydrate and lipid metabolism occur in the liver during fasting, such as an increase in gluconeogenesis and fatty acid oxidation, and reduced glycogenolysis (2325). Fasting also reduces glycemia and insulinemia and results in increased circulating free fatty acid concentrations. Tanis gene expression in the liver was increased 3.1-fold after 24 h of fasting in diabetic P. obesus but was not significantly increased in nondiabetic control animals. There was also a tendency for increased Tanis gene expression after fasting in the IGT group (2.5-fold increase; P = 0.072). Thus, we hypothesized that Tanis may be regulated by circulating metabolites such as glucose, insulin, or free fatty acid and may be involved in metabolic processes important in the development of type 2 diabetes. Subsequent expression profiling identified negative correlations between hepatic Tanis gene expression and circulating glucose and insulin concentrations and a positive association with plasma triglyceride concentration. Multiple linear regression analysis showed that only blood glucose concentration was independently associated with Tanis gene expression. Furthermore, hepatic expression of the Tanis gene was significantly reduced in type 2 diabetic P. obesus relative to their lean, healthy littermates. Cell culture experiments showed that glucose strongly inhibited Tanis gene expression in HepG2 hepatocytes, as well as in 3T3-L1 adipocytes and C2C12 muscle cells. Taken together, these results provide strong evidence that glucose is a key regulator of Tanis gene expression in the liver. In general, genes that are transcriptionally or translationally regulated by glucose tend to be involved in glucose/energy homeostasis, such as glucokinase (26) and fatty-acid synthase (27), or diseases associated with diabetes, such as atherosclerosis (CD36 gene (28). Regulation of Tanis gene expression by glucose could partially explain the differential response observed in fasted P. obesus, as the 24-h fast reduced blood glucose by only 0.85 mmol/l in NGT animals (4.23 ± 0.19 to 3.38 ± 0.25 mmol/l) compared with 8.64 mmol/l in diabetic P. obesus (13.48 ± 0.89 to 4.85 ± 0.32 mmol/l). Linear regression analysis confirmed that Tanis gene expression was associated with the change in glycemia after fasting and that this relationship was independent of body weight, glucose, and insulin concentrations at baseline and the change in insulinemia after fasting. The observations that Tanis gene expression in the liver is regulated by glucose, that the expression of Tanis is decreased in P. obesus with type 2 diabetes, and that there is exaggerated Tanis gene expression in response to fasting in these animals suggest that this gene may be important in key hepatic metabolic pathways. Tanis has characteristics consistent with a cell-surface receptor, and its mouse homologue (H47) was recently shown to reside at the cell surface membrane (29). We hypothesize that the increase in Tanis gene expression may correspond with increased appearance of this receptor at the cell surface of hepatocytes after fasting, which could in turn be important in the metabolic response to reduced energy intake. As most proteins exert their biological functions by interacting with other proteins, we reasoned that by knowing with which proteins Tanis interacts, we might be able to predict its function or assign a position in a known metabolic or signal transduction pathway. Yeast-2 hybrid screening of a human liver cDNA library resulted in identification of four independent positive clones. Additional sequencing revealed SAA as the main protein interacting with Tanis. SAA was considered to be a true positive as the interaction-mediated expression was positive for three built-in reporter genes for each of the clones. One could argue that the nuclear localization of two proteins expressed in yeast might give rise to false-positive interactions between proteins. To verify whether the observed interaction is true and occurs in a cell-free environment, we applied SPR analysis and examined interaction using purified Tanis and SAA proteins. A native form of SAA purified from human plasma as well as recombinant SAA, purified from bacteria as a GST-fusion protein, showed clear binding with recombinant Tanis, as observed by SPR in real time. Increasing amounts of Tanis passed over SAA immobilized on a sensor chip exhibited a concentration-dependent increase in SPR signal. The recombinant Tanis devoid of putative NH2-terminal and transmembrane regions also interacted with SAA, raising the possibility that the binding site is located within 136 amino acid residues in the COOH-terminal region. SAA comprises a family of acute-phase inflammatory response proteins that are found in all vertebrates and are expressed primarily in the liver. They are classified as acute-phase A-SAAs or constitutive C-SAAs on the basis of their response to inflammatory stimuli. When challenged with inflammation under a variety of conditions, the concentration of A-SAAs in the circulation increases up to 1,000-fold, at times reaching 1 mg/ml. The relationship between inflammation, in particular the acute-phase response, and chronic diseases such as type 2 diabetes and atherosclerosis has been the subject of recent investigation. Blood concentrations of markers of the acute-phase response, including SAA, C-reactive protein, and interleukin-6, are elevated in type 2 diabetes (3034). In addition, a recent prospective study showed that elevated circulating acute-phase response proteins predicted the development of type 2 diabetes in a cohort of >27,000 U.S. women (34), supporting a role for inflammation in diabetogenesis. Increased circulating levels of these proteins have also been associated with increased overall mortality and cardiovascular mortality (3538). Indeed, it has been suggested that type 2 diabetes and atherosclerosis both may represent chronic inflammatory processes that are exacerbated by increased circulating levels of these acute-phase proteins (35,39). SAA is synthesized in the liver and incorporated in HDL cholesterol when released into the circulation. Alteration of HDL metabolism and cholesterol transport that could promote a proatherogenic phenotype has been proposed as a possible mechanism to explain the link between type 2 diabetes and atherosclerosis (40, 41). Therefore, we hypothesize that Tanis is a novel hepatic receptor for SAA and that its expression is regulated by glucose. Both the Tanis receptor itself and its interaction with SAA represent new targets with great potential for the development of treatment and/or preventive strategies in type 2 diabetes, dyslipidemia, and cardiovascular disease, as well as other diseases with chronic inflammatory components, such as rheumatoid arthritis. Additional investigation into the relationship between Tanis and SAA may also lead to the identification of a biochemical mechanism that explains the link between inflammation and type 2 diabetes. In summary, we identified a novel gene (Tanis) whose expression is markedly influenced by glucose and is dysregulated after fasting in the diabetic state. The Tanis protein seems to be a receptor that binds to SAA, an acute-phase inflammatory response protein previously implicated in the development of type 2 diabetes and atherosclerosis. We suggest that Tanis represents a new target for the development of therapeutic agents for type 2 diabetes and cardiovascular disease.
Funding for this work was provided by Autogen, Australia.
Address correspondence and reprint requests to Ken Walder, School of Health Sciences, Deakin University, Waurn Ponds, Victoria 3217, Australia. E-mail: walder{at}deakin.edu.au. Received for publication 11 September 2001 and accepted in revised form 25 February 2002. P.Z.Z. receives laboratory funds from Autogen, a biotechnology company involved in the discovery of genes and proteins in diabetes and obesity. 3AT, 3-amino-1,2,4-triazole; IGT, impaired glucose tolerant; NGT, normal glucose tolerant; RU, resonance units; SAA, serum amyloid A; SPR, surface plasmon resonance.
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