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In this study, we investigated whether PPARc modulates visfatin expression in murine bone marrow-derived macrophage and human primary human resting macrophage, classical macrophage, alte

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receptor gamma in human macrophages

The´re`se He`rve´e Mayi1,2,3,4, Christian Duhem1,2,3,4, Corinne Copin1,2,3,4, Mohamed Amine

Bouhlel1,2,3,4, Elena Rigamonti1,2,3,4, Franc¸ois Pattou1,5,6, Bart Staels1,2,3,4and Giulia

Chinetti-Gbaguidi1,2,3,4

1 Univ Lille Nord de France, France

2 Inserm, Lille, France

3 UDSL, Lille, France

4 Institut Pasteur de Lille, France

5 Service de Chirurgie Ge´ne´rale et Endocrinienne, Centre Hospitalier Re´gional et Universitaire de Lille, France

6 Inserm ERIT-M 0106, Faculte´ de Me´decine, Lille, France

Keywords

adipocytokines; inflammation; macrophages;

nuclear receptors; visfatin

Correspondence

Bart Staels, Inserm UR 1011, Institut

Pasteur de Lille, 1, rue du Professeur

Calmette, BP 245, Lille 59019, France

Fax: +33 3 20 87 73 60

Tel: +33 3 20 87 73 88

E-mail: bart.staels@pasteur-lille.fr

(Received 15 January 2010, revised 27 April

2010, accepted 3 June 2010)

doi:10.1111/j.1742-4658.2010.07729.x

Obesity is a low-grade chronic inflammatory disease associated with an increased number of macrophages (adipose tissue macrophages) in adipose tissue Within the adipose tissue, adipose tissue macrophages are the major source of visfatin⁄ pre-B-cell colony-enhancing factor ⁄ nicotinamide phos-phoribosyl transferase The nuclear receptor peroxisome proliferator-acti-vated receptor gamma (PPARc) exerts anti-inflammatory effects in macrophages by inhibiting cytokine production and enhancing alternative differentiation In this study, we investigated whether PPARc modulates visfatin expression in murine (bone marrow-derived macrophage) and human (primary human resting macrophage, classical macrophage, alterna-tive macrophage or adipose tissue macrophage) macrophage models and pre-adipocyte-derived adipocytes We show that synthetic PPARc ligands increase visfatin gene expression in a PPARc-dependent manner in primary human resting macrophages and in adipose tissue macrophages, but not in adipocytes The threefold increase of visfatin mRNA was paralleled by an increase of protein expression (30%) and secretion (30%) Electrophoretic mobility shift assay experiments and transient transfection assays indicated that PPARc induces visfatin promoter activity in human macrophages by binding to a DR1–PPARc response element Finally, we show that PPARc ligands increase NAD+ production in primary human macrophages and that this regulation is dampened in the presence of visfatin small interfering RNA or by the visfatin-specific inhibitor FK866 Taken together, our results suggest that PPARc regulates the expression of visfatin in macro-phages, leading to increased levels of NAD+

Abbreviations

AcLDL, acetylated low-density lipoprotein; AP-1, activator protein 1; ATM, adipose tissue macrophages; EMSA, electrophoretic mobility shift assay; IL, interleukin; NAMPT, nicotinamide phosphoribosyl transferase; M1, classical pro-inflammatory macrophage phentotype; M2, alternative anti-inflammatory macrophage phenotype; NF-jB, nuclear factor-kappaB; NR, nuclear receptor; PBEF, pre-B-cell colony-enhancing factor; PPARc, peroxisome proliferator-activated receptor gamma; PPRE, peroxisome proliferator-activated receptor response elements; Q-PCR, quantitative PCR; ROS, reactive oxygen species; RM, resting macrophages; RSG, rosiglitazone; RXR, retinoic X receptor; siRNA, small interfering RNA; SIRN, sirtuin (silencing mating type information regulation 2 homolog); SMC, smooth muscle cells; TNF-a, tumor necrosis factor alpha.

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Originally discovered in liver, skeletal muscle and

bone marrow, and also known as pre-B-cell

colony-enhancing factor (PBEF), a cytokine acting in B-cell

differentiation [1], visfatin, is nicotinamide

phosphori-bosyl transferase (NAMPT) [2,3], a rate-limiting

enzyme in the synthesis of NAD+ from

nicotin-amide Visfatin⁄ PBEF ⁄ NAMPT is synthesized and

secreted in adipose tissue by adipocytes, and mostly

by macrophages, and circulates in the plasma of

humans and mice [4] Plasma concentrations of

visfa-tin are positively associated with cytokines such as

interleukin (IL)-6 and increase in morbidly obese

subjects Elevated circulating levels of visfatin have

been observed in many inflammatory diseases such

as rheumatoid arthritis, obesity, insulin resistance

and type 2 diabetes [5–7] Visfatin is secreted by

neutrophils in response to inflammatory stimuli and

is regulated in monocytes by pro-inflammatory

fac-tors such as IL-1b, tumor necrosis factor alpha

(TNF-a), IL-6 via nuclear factor-kappaB (NF-jB)

and AP-1-dependent mechanisms [8–10] Visfatin

acti-vates pro-inflammatory signalling pathways in human

endothelial and vascular smooth muscle cells (SMC)

through reactive oxygen species (ROS)-dependent

NF-jB activation or NAMPT activity, respectively,

and therefore could provide a link between obesity

and atherothrombotic diseases [11,12] Visfatin

func-tions as an extracellular and intracellular NAD

bio-synthetic enzyme that converts, in mammals,

nicotinamide (a form of vitamin B3) to NMN,

a NAD precursor Thus, the NAD pool is maintained,

at least in part, by visfatin, which is important, for

instance, in b-cell insulin secretion [2] Although still

controversial, visfatin is thought to have insulin

mimetic effects and, similarly to insulin, visfatin

enhances glucose uptake by myocytes and adipocytes

and inhibits hepatocyte glucose release in vitro [13,14]

Altogether, the pleiotropic role of visfatin suggests that

the regulation of NAD+synthesis is critical for several

aspects of cell physiology [15]

Macrophages, crucial cells in the development of

inflammatory and metabolic disorders such as

athero-sclerosis and obesity, are a heterogeneous cell

popula-tion that adapts and responds to a large variety

of microenvironmental signals [16] The activation

states and functions of macrophages are regulated

by several cytokines and microbial products T helper

1 cytokines, such as interferon-gamma, IL-1b or

lipopolysaccharide (LPS), induce activation of a

classi-cal pro-inflammatory macrophage phenotype (M1),

whereas T helper 2 cytokines, such as IL-4 and IL-13,

induce an alternative anti-inflammatory macrophage phenotype (M2) [17] In macrophages, many genes are regulated by transcription factors, such as the nuclear receptors (NRs), which translate physiological signals into gene regulation Peroxisome proliferator-activated receptor gamma (PPARc) is a NR that regulates genes controlling lipid, glucose metabolism and inflammation After activation by its ligands, PPARc forms a hetero-dimer with the retinoic X receptor (RXR) [18] The binding of this heterodimer to specific DNA sequences, called PPAR response elements (PPRE), results in the regulation of its target genes [18] In this way PPARc modulates crucial pathways of adipocyte differentiation and lipid metabolism, thus impacting on glucose metab-olism and insulin sensitivity Furthermore, activated PPARc inhibits inflammatory response genes by nega-tively interfering with the NF-jB, signal transducers and activators of transcription (STAT) and AP-1 signal-ing pathways in a DNA-bindsignal-ing independent manner [19] This trans-repression activity is probably the basis for the anti-inflammatory properties of PPARc

PPARc is activated by natural or synthetic ligands such as GW1929 and the antidiabetic thiazolidinedi-ones rosiglitazone (RSG) and pioglitazone [20] PPARc expression is very low in human monocytes, but is induced upon differentiation into macrophages and is present in foam cells of atherosclerotic lesions [21–23] More recently, PPARc has been shown to enhance the differentiation of monocytes into alterna-tive anti-inflammatory M2 macrophages [24,25] and to promote the infiltration of M2 macrophages into adi-pose tissue [26] Consistent with these results, selective inactivation of macrophage PPARc in BALB⁄ c mice results in an impairment in the maturation of alterna-tively activated M2 macrophages and in the exacerba-tion of diet-induced obesity, insulin resistance, glucose intolerance and expression of inflammatory mediators [24,27] All these studies provide evidence that macro-phage PPARc is a central regulator of inflammation and insulin resistance

Here, we identify visfatin as a novel PPARc-regu-lated gene in human macrophages Interestingly, PPARc activation enhanced visfatin gene expression in both M1 and M2 human macrophages, but not in murine macrophages or in human adipocytes Finally,

we show that intracellular NAD+concentrations cor-relate with visfatin protein expression upon PPARc ligand activation Reduction of visfatin expression and activity by small interfering RNA (siRNA) or a spe-cific inhibitor abolished the PPARc-mediated increase

of NAD+

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PPARc agonists induce visfatin gene expression

in human macrophages in a PPARc-dependent

manner

To investigate whether PPARc regulates visfatin gene

expression, quantitative PCR (Q-PCR) analysis was

performed in primary human resting macrophages

(RM) upon PPARc activation Time course

experi-ments showed that visfatin induction was already

observed after 9 h of stimulation with GW1929

(600 nm) or RSG (100 nm) and became maximal at

24 h (Fig 1A), with no significant further increase

after 48 h (data not shown) Treatment of RM with

increasing concentrations of the PPARc ligands

GW1929 (300, 600 and 3000 nm) or RSG (50, 100 and

1000 nm) for 24 h significantly increased visfatin

mRNA levels in a concentration-dependent manner

(Fig 1B) Expression of CD36, a known PPARc target

gene [23], was also induced to a similar extent in a dose-dependent manner (data not shown) Interest-ingly, visfatin regulation by PPARc was also observed

in macrophage foam cells, obtained by acetylated low-density lipoprotein (AcLDL) loading (Fig 1C) Moreover, GW1929 (600 nm) also regulated visfatin expression in infiltrated adipose tissue macrophages (ATM) derived from visceral fat depots (Fig 1D) To determine whether PPARc agonists up-regulate visfatin expression in a PPARc-dependent manner, the effect

of GW1929 (600 nm) was analysed in the presence or

in the absence of the PPARc inhibitor, T0070907 (1 lm) [28] T0070907 abolished GW1929-induced visf-atin mRNA expression (Fig 1E) Furthermore, infec-tion of RM with PPARc-expressing adenovirus resulted in a significant further increase of visfatin expression in the presence of the agonist (Fig 1F) Expression of two PPARc target genes, CD36 and FABP4 (aP2), used as positive controls, was also increased (Fig 1G,H) Taken together, these data

AcLDL

1

2

Visfatin/cyclophilin mRNA Visfatin/cyclophilin mRNA CD36/cyclophilin mRNA FABP4/cyclophilin mRNA

Visfatin/cyclophilin mRNA Visfatin/cyclophilin mRNA Visfatin/cyclophilin mRNA

3

4

3 h 6 h 9 h 12 h 24 h

GW1929

RSG

Control

A

** **

***

***

1 2 3 4

6 5

**

***

***

C

1 2 3 4

B

0

*

*

*

*

*

5

D

0.5 1 1.5 2

2.5

*

ATM

1

2

3

Control T00709

E

*

1 2 3

AdGFP AdPPAR

γ

AdGFP AdPPAR

γ

AdGFP AdPPAR

γ

F

4

RSG Control

***

***

*

Control GW1929

§

RSG Control

RSG

Control

Control GW1929

1 2

3 RSG Control

G

1 2 3 4 5 6 7

***

***

*

***

***

*

RSG Control H

Fig 1 PPARc agonists regulate visfatin gene expression in human macrophages in a PPARc-dependent manner Primary human

macrophag-es were incubated or not (control) with (A) GW1929 (600 n M ) or RSG (100 n M ), for the indicated periods of time, or (B) with GW1929 (300,

600 and 3000 n M ) or RSG (50, 100 and 1000 n M ) for 24 h, or (C) were transformed into foam cells by AcLDL (50 lgÆmL)1) loading before treat-ment with PPARc ligands (D) Human visceral ATM were treated with GW1929 (600 n M ) for 24 h (E) Primary human monocytes were differ-entiated in macrophages in the presence or absence of GW1929 (600 n M ), T0070907 (1 l M ), or both, which were added at the start of the differentiation Primary human macrophages were infected with recombinant adenovirus AdGFP or AdPPARc and treated with RSG (100 n M ) for 24 h Visfatin (F), CD36 (G) and FABP4 (H) mRNA were analyzed by quantitative PCR and normalized to cyclophilin mRNA The results are representative of those obtained from three independent macrophage preparations and are expressed relative to the levels in untreated cells set as 1 Each bar is the mean value ± SD of triplicate determinations Statistically significant differences between treatments and controls are indicated (t-test; *P < 0.05; **P < 0.01; ***P < 0.001; T00709 + G929 versus GW1929 § P < 0.05).

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demonstrate that PPARc ligands induce visfatin gene

expression in human macrophages through a

PPARc-dependent mechanism

PPARc agonists do not regulate visfatin gene

expression in murine macrophages or human

adipocytes

To determine whether regulation of visfatin also occurs

in mouse macrophages, experiments were performed in

murine bone marrow-derived macrophages that were

treated with GW1929 (1200 nm) or RSG (1000 nm) for

24 h PPARc activation did not increase visfatin gene

expression, although expression of CD36 was induced

(Fig 2A,B) Similar results were observed with the

murine macrophage cell line, RAW264.7, when

incu-bated with increasing concentrations of GW1929 and

RSG (data not shown) Furthermore, activation of

PPARc by exposure to GW1929 (600 nm) for 24 h did

not lead to an increased expression of visfatin in

human mature adipocytes derived from the

differentia-tion of primary pre-adipocytes in vitro, while the expression of CD36 was strongly induced (Fig 2C,D) Similar results were obtained in the murine pre-adipo-cyte cell line, 3T3L1, after treatment with RSG or pioglitazone (data not shown), in line with a previous report [29]

PPARc regulates visfatin gene expression at the transcriptional level

To determine whether visfatin is a direct PPARc target gene, the human visfatin promoter was examined by bio-informatic analysis Three putative DR1-like PPRE motifs were identified in the 2150-bp sequence upstream of the ATG start site of the visfatin gene [30] Among these sites, only the putative PPRE identi-fied at position -1501⁄ -1513 (AGGGCA A AGATCA) was found to be functional in electrophoretic mobility shift assay (EMSA) experiments (Fig 3A) Incubation

of the labeled -1501⁄ -1513 visfatin–PPRE oligonucleo-tide with in vitro-translated PPARc and RXRa resulted in the formation of a retarded complex (Fig 3A, lane 6) The binding specificity of PPARc to this DR1–visfatin–PPRE site was demonstrated by competitive inhibition with excess cold unlabeled wild-type (Fig 3A, lanes 7-11), but not mutated (Fig 3A, lanes 12-17), visfatin–PPRE oligonucleotide, as well as

by the supershift with a specific anti-human PPARc IgG1(Fig 3A, lane 18) Binding of RXRa and PPARc

to labelled DR1-consensus PPRE was assayed as a positive control (Fig 3A, lane 2)

To determine whether PPARc activates transcription from the (-1501⁄ -1513) PPRE site, six copies of this element were cloned in front of the heterologous her-pes simplex virus thymidine kinase promoter to obtain the (DR1–visfatin–PPRE)6x-Tk-Luc luciferase reporter vector Co-transfection of the pSG5–PPARc expres-sion vector with the (DR1–visfatin PPRE)6 reporter vector in primary human RM led to a significant induction of transcriptional activity compared with the pSG5 empty vector, an effect enhanced in the presence

of GW1929 (600 nm) (Fig 3B) The consensus DR1– PPRE site cloned in six copies (DR1–consensus PPRE)6, used as a positive control, was strongly induced by PPARc (Fig 3B) Taken together, these results indicate that visfatin is a direct PPARc target gene in human macrophages

PPARc activation induces visfatin gene expression in M1 and M2 macrophages

As macrophages are heterogeneous cells [16,17], we decided to investigate whether induction of visfatin

2

RSG

Control

GW1929

*

1.2

1.4

RSG GW1929

*

1

0.4 0.6 0.8 1

0.2

3

mCD36/cyclophilin mRNA mVisfatin/cyclophilin mRNA

1.4

2

2.5

1 1.2

***

Control

GW1929

Control GW1929

1

1.5

CD36/cyclophilin mRNA Visfatin/cyclophilin mRNA

0.4 0.6 0.8

Fig 2 PPARc agonists do not regulate visfatin gene expression in

murine macrophages or human adipocytes (A, B) Murine bone

marrow-derived macrophages (BMDM) were incubated or not

(con-trol) in the presence of PPARc ligands GW1929 (1.2 l M ) or RSG

(1 l M ) (C, D) Human mature adipocytes derived from the

differenti-ation of pre-adipocytes in vitro were incubated or not (control) in

the presence of PPARc ligands GW1929 (600 n M ) CD36 (A, B) and

visfatin (C, D) mRNA were analyzed using quantitative PCR and

normalized to cyclophilin mRNA The results are representative of

at least three independent cell preparations and are expressed

rela-tive to the levels in untreated cells set as 1 Each bar is the mean

value ± SD of triplicate determinations Statistically significant

differences between treatments and controls are indicated (t-test;

*P < 0.05; ***P < 0.001).

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also occurs after PPARc activation in classical (M1) or

alternative (M2) macrophages Human monocytes were

differentiated in vitro into RM macrophages and

acti-vated into inflammatory M1 macrophages with

recom-binant human TNF-a (5 ngÆmL)1), IL-1b (5 ngÆmL)1)

or LPS (100 ngÆmL)1) As expected [8], expression of

visfatin was strongly induced by pro-inflammatory

stimuli (Fig 4A) Interestingly, the effects of TNF-a

and LPS treatment were amplified in the presence of the PPARc agonist GW1929 (Fig 4A) Under the same experimental conditions, PPARc inhibited the induction of TNF-a or IL-1b induced by inflammatory stimuli, indicative of its anti-inflammatory activity (data not shown)

In parallel experiments, human monocytes were dif-ferentiated in vitro into M2 macrophages with recom-binant IL-4 (15 ngÆmL)1) in the absence or in the presence of the PPARc agonist GW1929 added at the start of the differentiation process [25] As shown in Fig 4B, the expression of visfatin was significantly decreased by IL-4 stimulation However, as with RM, the PPARc agonist GW1929 enhanced visfatin gene expression in M2 macrophages A similar regulation was observed in monocytes differentiated into M2 macrophages in the presence of IL-13 (data not shown)

PPARc activation regulates visfatin protein expression and secretion in human macrophages

To determine whether visfatin gene induction by PPARc agonists leads to an increased protein level,

A

Ab anti-PPAR γ Lysate RXR Lysate

α + PPAR

γ

PPAR γ RXR

α

RXR α + PPARγ Cold DR1 Visfatin-PPRE Cold DR1 Visfatin-PPRE

2 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

1

DR1-consensus

PPRE

DR1-Visfatin-PPRE wt

3

B

pSG5

**

2

4

6

8

10

12

14

(DR1-Visfatin PPRE)6

pSG5-PPAR γ

Control

GW1929

§§

(DR1-consensus PPRE)6

**

*

10 20 30 40 50

60

70 Control

GW1929

pSG5 pSG5-PPAR γ

§§§

Fig 3 PPARc binds to and activates a PPRE in the human visfatin

gene promoter (A) EMSAs were performed using the end-labeled

DR1–consensus–PPRE (lanes 1 and 2) or the DR1–visfatin–PPREwt

oligonucleotide in the presence of unprogrammed reticulocyte lysate

or in vitro-translated human PPARc and human RXRa (lanes 3–5).

Competition experiments were performed in the presence of excess

cold unlabeled wild-type (wt) (lanes 6–11) or mutated (mut) DR1–

visfatin–PPRE oligonucleotides (lanes 12-17) Supershift assays

were performed using an anti-human PPARc Ig (lane 18) (B) Primary

human macrophages were transfected with the indicated reporter

constructs (DR1–visfatin–PPRE) 6 or (DR1–consensus–PPRE) 6 , in the

presence of pSG5 empty vector or pSG5–PPARc Cells were treated

or not (Control) with GW1929 (600 n M ) and luciferase activity

was measured Statistically significant differences are indicated

(pSG5 versus pSG5-PPARc;§§P < 0.01,§§§P < 0.001; control versus

GW1929 *P < 0.05, **P < 0.01) b-gal, beta-galactosidase; RLU,

relative luciferase units.

1 2 Visfatin/cyclophilin mRNA Visfatin/cyclophilin mRNA

3 4 5 6 7

IL-1β

TN

F-α

LPS

2

GW1929 Control

*

*

***

***

**

**

ns

0.5 1 1.5 2 2.5

§§

Control

**

**

*

*

*

GW1929

Fig 4 PPARc agonists induce visfatin gene expression in M1 and M2 macrophages (A) Primary human monocytes were differenti-ated to RM and tredifferenti-ated for 24 h with GW1929 (600 n M ) Where indicated, RM were activated to M1 macrophages by incubation with recombinant human TNF-a (5 ngÆmL)1) or recombinant human IL-1b (5 ngÆmL)1) for 4 h or with LPS (100 ngÆmL)1) for 1 h after GW1929 treatment (B) Primary human monocytes were differenti-ated in RM or M2 macrophages in the presence of IL-4 (15 ngÆmL)1), and the PPARc agonist GW1929 (600 n M ) was added

or not during the differentiation process Visfatin mRNA was ana-lyzed using Q-PCR and normalized to cyclophilin mRNA The results are representative of those obtained from five independent macro-phage preparations and are expressed relative to the levels in untreated cells set as 1 Each bar is the mean value ± SD of triplicate determinations Statistically significant differences between treatments and controls are indicated (control versus PPARc agonists *P < 0.05, ***P < 0.001; control versus cytokines

§ P < 0.05, §§ P < 0.01).

Trang 6

western blot analysis was performed on human RM

treated with GW1929 (600 nm) or dimethylsulfoxide

for 24 h Activation of PPARc caused a significant

increase (approximately 30%) of visfatin protein

expression (Fig 5A) To examine whether this

induc-tion was followed by an increased secreinduc-tion, we exam-ined the ability of PPARc to stimulate visfatin release

As shown in Fig 5B, GW1929 markedly increased (approximately 30%) the visfatin concentration in macrophage supernatants after 24 h of treatment

PPARc activation increases the intracellular NAD+ concentration in human macrophages

As visfatin is known as a nicotinamide phosphoribosyl transferase [2], we investigated whether the induction

of visfatin by PPARc affects the concentration of NAD+ Human RM were treated or not with GW1929 (600 nm) for 24 h and intracellular NAD+ levels were determined using an enzymatic assay Our results showed that PPARc activation significantly enhances the cellular NAD concentration (Fig 6), an effect in line with the observed induction of visfatin expression (Figs 1 and 5)

To determine whether the NAD+ enhancement by PPARc was dependent on visfatin induction, experi-ments were performed in RM macrophages in the absence or in the presence of a specific visfatin siRNA Q-PCR analysis showed a significant decrease in visfa-tin gene expression after siRNA (scrambled = 1 ± 0.019 versus siRNA visfatin = 0.27 ± 0.01), whereas PPARc activation increased visfatin gene expres-sion (scrambled + GW1929 = 2.04 ± 0.4 and siRNA visfatin + GW1929 = 0.51 ± 0.022) siRNA-mediated visfatin knockdown resulted in a reduction of the basal, as well as of the GW1929-induced, NAD+ con-centration (Fig 6A) Moreover, experiments performed

Visfatin β-actin

GW1929 Control

Control GW1929

0.4

0.8

1.2

1.6

GW1929 Control

0.2

0.6

1.0

0.5 1 1.5 2 2.5

Fig 5 PPARc regulates visfatin protein expression and secretion

in primary human macrophages Primary human macrophages were

treated or not (control) with GW1929 (600 n M ) for 24 h (A)

Intracel-lular visfatin and b-actin protein expression was analyzed by

wes-tern blotting and relative signal intensities were quantified using

Quantity One Software The results are representative of four

inde-pendent macrophage preparations and are expressed relative to the

levels in untreated cells set as 1 (B) Secretion of visfatin protein

was quantified in the macrophage supernatant using ELISA The

results are representative of three independent macrophage

prepa-rations Each bar is the mean value ± SD of triplicate

determina-tions Statistically significant differences between treatments and

controls are indicated (t-test; *P < 0.01; ***P < 0.001).

100 120 140

100 120 140

*

*

*

GW1929 Control

60 80

60 80

§

**

+ concentration (%)

20 40

Scrambled siRNA visfatin

20 40

+ concentration (%)

+ concentration (%)

Vehicle

150

RSG

Control GW1929

§

** **

§

GW1929 Control

130 140

§§

110 120

130

*

90

AdPPARγ 100

Fig 6 PPARc activation affects intracellular NAD concentrations in primary human macrophages Primary human macrophages were trans-fected or not with non-silencing control or silencing siRNA against human visfatin (A), or treated or not with the visfatin inhibitor FK866 (100 n M ) (B), or infected or not with PPARc-expressing (AdPPARc) or GFP (AdGFP) adenovirus (C) and subsequently treated with GW1929 (600 n M ), RSG (100 n M ) or dimethylsulfoxide for 24 h Cells were lysed in NAD extraction buffer and the NAD + concentrations were mea-sured using an enzymatic cycling reaction assay, normalized to protein levels and expressed as a percentage, the control non-stimulated cells being expressed as 100% The results are representative of those obtained from three independent macrophage preparations The val-ues are means ± SD of triplicates Statistically significant differences are indicated (t-test; control versus PPARc agonists, *P < 0.05,

**P < 0.01; scrambled versus siRNA visfatin or vehicle versus FK866, § P < 0.05, §§ P < 0.05; AdGFP + PPARc agonists versus AdPPARc + PPARc agonists, § P < 0.05) GFP, green fluorescent protein.

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in the presence of a specific noncompetitive inhibitor

of visfatin (FK866) in the presence or absence of

GW1929 demonstrated that the induction of NAD+

by GW1929 was inhibited in the presence of FK866

(Fig 6B) Finally, PPARc over-expression increased

NAD+ levels, an effect enhanced by its synthetic

ligands GW1929 and RSG (Fig 6C)

Discussion

Visfatin has been suggested to act as an

inflamma-tory mediator, being expressed in blood monocytes

and foam cell macrophages within unstable

athero-sclerotic lesions where it potentially plays a role in

plaque destabilization [8,31] Visfatin induces

leuko-cyte adhesion to endothelial cells by inducing the

expression of the cell-adhesion molecules intercellular

adhesion molecule 1 (ICAM-1) and vascular cell

adhesion molecule 1 (VCAM-1), thus potentially

contributing to endothelial dysfunction [11]

More-over, visfatin increases matrix metalloproteinase-9

activity and the expression of TNF-a and IL-8 in

THP-1 monocytes [8] These effects of visfatin were

abolished when insulin receptor signalling was blocked

[8], in line with the report that visfatin could bind and

activate insulin receptors [14] However, the

insulin-mimetic actions of visfatin are still debated [13] All

these data suggest that visfatin might be a player

linking several inflammatory pathologies, including

obesity-associated insulin resistance, diabetes mellitus

and vascular wall dysfunctions [9,32]

In this study we showed that PPARc activation

up-regulates the expression of visfatin in human

mono-cyte-derived macrophages and ATM This induction is

concentration dependent and does not occur during

the short incubation time generally required for

macro-phage activation, but requires an incubation period of

more than 9 h The maximum effect was obtained at

24 h with no significant further increase at 48 h (data

not shown) In addition, treatment with AcLDL

induced visfatin mRNA levels, and PPARc activation

further increased visfatin expression in these

AcLDL-loaded macrophages

By over-expressing PPARc with adenovirus

con-structs, or by inhibiting PPARc with a specific

antago-nist, we demonstrated that PPARc agonists induce

visfatin gene expression in a PPARc-dependent

man-ner [33] By bio-informatics analysis, we detected the

presence of three DR1-like motifs that might serve as

PPREs in the 2150-bp sequence upstream of the ATG

codon of the human visfatin gene [30] Using EMSA

and transient transfection experiments in primary

human macrophages, a functional PPRE was identified

at position -1501⁄ -1513 within the promoter This PPRE is distinct from the described AP-1 or NF-jB– response element (RE) like elements (located at posi-tion -1757⁄ -1767) within the human visfatin promoter [30] This can explain our observation that inflamma-tory cytokines and PPARc agonists have an additive effect on visfatin mRNA expression, an effect appar-ently in contrast to the known anti-inflammatory actions of PPARc in macrophages as a result of its ability to interfere with the NF-jB and AP-1 signaling pathways [19] This is similar to what has already been reported for other nuclear receptors, such as liver X receptor, for which short-term pretreatment with liver

X receptor agonists significantly reduced the LPS-induced inflammatory response, whereas 24-h pretreat-ment of macrophages with agonists resulted in an enhanced inflammatory response [34]

PPARc agonists induce visfatin protein expression and secretion in human primary macrophages Visfatin

is a secreted cytokine-like protein [35], although it has been speculated that the release of visfatin may be caused either by cell lysis or by cell death [36,37] However, it has been demonstrated in adipocytes and Chinese Hamster ovary (CHO) cells that visfatin is actively secreted through a nonclassical (non-Golgi⁄ endoplasmic reticulum system) secretory path-way [2] In our experiments we did not observe any cellular toxicity after treatment with PPARc agonists, suggesting that the secretion of visfatin in human mac-rophages may be an active process

As visfatin is the rate-limiting enzyme for the con-version of nicotinamide to NAD+ in mammals, the increased concentration of intracellular NAD+ induced by PPARc agonists is probably the conse-quence of visfatin induction NAD+ modulates vari-ous signalling pathways For instance, it regulates the transcription and function of NAD+-dependent

SIR-Ts, and increased expression of visfatin upregulates sirtuin 1(SIRT1) activity [2] The observed variation of intracellular NAD+concentrations after visfatin mod-ulation (by siRNA or PPARc activation) are in the same order of magnitude as previously reported in murine NIH-3T3 fibroblasts transduced with visfatin-specific small hairpin RNA (shRNA) The reduction of intracellular visfatin protein in these cells led to a reduction of NAD+levels from 20% to 40%, whereas cells over-expressing visfatin displayed a 15–25% increase in total intracellular NAD+ levels [38] By using the pharmacological visfatin inhibitor, FK866, a significant decrease in the intracellular NAD+ concen-tration was observed, even in the presence of PPARc ligand, confirming the role of the enzymatic activity of visfatin and the possibility that PPARc can modulate

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intracellular NAD+ levels via an increase of visfatin

expression Indeed, a small increase in the

concentra-tion of NAD+in response to GW1929 in siRNA

visf-atin treated-macrophages was observed, suggesting

that an additional PPARc-related pathway might

mod-ulate NAD+levels

Moreover, we have shown that PPARc agonists

increase the expression of visfatin in macrophages

irre-spective of their M1 or M2 polarization

Visfatin-depen-dent recycling of nicotinamide to NAD+may represent

a physiologically important homeostatic mechanism to

avoid depletion of the intracellular NAD+pool during

its active use as a substrate by sirtuins, cADP-ribose

synthases or PARPs [15] It has recently been shown

that pharmacological SIRT1 activators exert broad

anti-inflammatory effects in macrophages [39]

Con-versely, SIRT1 knockdown leads to an increase in the

basal expression of TNF-a, monocyte chemoattractant

protein 1 (MCP-1) and keratinocyte-derived chemokine

(KC) The activity of SIRT1 requires an increase of

visfatin expression to compensate for the consumption

of NAD+ Van Gool et al have identified SIRT6,

another member of the sirtuin family, as the

NAD-dependent enzyme able to increase TNF-a production

in macrophages by acting post-transcriptionally [40]

Taken together, these observations suggest that NAD+

can exert pro- and⁄ or anti-inflammatory properties

depending on the activated sirtuins

It is also possible that macrophage-produced visfatin

has a local paracrine effect on surrounding cells, such

as SMC, within atherosclerotic plaques, because in

vascular SMC, over-expression of visfatin promotes

cell maturation by regulating NAD+-dependent SIRT

deacetylase activity [41] Visfatin has been reported as

a longevity protein that extends the life span of human

SMC, suggesting that visfatin allows vascular cells to

resist stress and senescence, a hallmark of

atheroscle-rotic lesions [42] The ability of visfatin to prolong the

longevity of vascular SMC might contribute to the

sta-bilization efficiency of a developing atherosclerotic

lesion by SMC Treatment of humans with PPARc

ligands does not alter adipose visfatin gene expression

and circulating visfatin levels, as reported in several

publications [43–45] However, other authors reported

that in lean as well as in lean-HIV-infected patients,

RSG treatment increased the amounts of circulating

visfatin [46,47] It thus appears that the effect of

treat-ment with PPARc ligand on circulating visfatin levels

is highly dependent on the patient phenotype

How-ever, in such studies the net contribution of visfatin

from adipocytes or macrophages cannot be evaluated

and cell-specific PPARc regulation of visfatin may

have a local effect

Adipose tissue is composed not only of adipocytes, but also of several other types of cells, including macrophages, lymphocytes and endothelial cells It has been shown that PPARc agonists induce the expression of visfatin in the visceral fat of OLETF rats [48] The authors analyzed whole adipose tissue, and thus it cannot be determined whether PPARc regulation of visfatin occurred in macrophages or in adipocytes Here we show that PPARc activation leads to an increased expression of visfatin in ATM However, this regulation does not occur in human primary mature adipocytes derived from pre-adipocyte differentiation in vitro It has been shown recently that PPARc binding in macrophages occurs at genomic locations different from those in adipocytes, showing that PPARc-binding sites are cell type-specific [49] These results are in agreement with a previous report showing that in humans, PPARc has distinct func-tions in different cell types because treatment with pioglitazone induces apoptotic cell death specifically

in macrophages, whereas differentiated adipocytes did not show any significant increase in apoptosis [50] Furthermore, treatment with pioglitazone for 3 weeks did not alter visfatin gene expression in adipose cells,

in either non-diabetic or diabetic individuals [43] Altogether, these results may allow some light to be shed on the regulation of visfatin expression by PPARc in human adipose tissue, an effect limited to ATM

In conclusion, our results identify visfatin as a novel PPARc target gene in human macrophages and dem-onstrate that PPARc activation induces visfatin gene and protein secretion in different types of human macrophages This induction of visfatin by PPARc in macrophages contributes to enhanced concentrations

of intracellular NAD+

Materials and methods

Cell culture Mononuclear cells were isolated from blood (buffy coats; thrombopheresis residues) of human healthy

normolipidem-ic donors by Fnormolipidem-icoll gradient centrifugation [21] Briefly, after Ficoll gradient centrifugation, peripheral blood mono-nuclear cells were suspended in RPMI-1640 (Gibco,

(0.05%) (both from Gibco, Invitrogen) Cells were cultured, depending on the experiment, at a density of 1 or

2· 106

cells per well in six-well plastic culture dishes (Pri-maria; Becton Dickinson Labware) Selection of a pure monocyte population occurred spontaneously after 2 h of cell adhesion to the culture dish After two washing

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steps with NaCl⁄ Pi, cells were cultured in RPMI-1640

con-taining gentamycin (40 lgÆmL)1), glutamine (0.05%) and

10% pooled human serum (Biowest, Nuaille´, France)

Dif-ferentiation of monocytes into macrophages is completed

after 7 days, characterized by immunocytochemistry or flow

cytometry analysis using macrophage marker anti-CD68

antibody [21] These primary human macrophages, also

called RM, were used for experiments after 7 days of

differ-entiation RM were incubated for 3, 6, 9, 12 or 24 h in the

presence of the PPARc ligands GW1929 (300, 600,

3000 nm) or RSG (50, 100, 1000 nm), or with

dimethylsulf-oxide as a control Where indicated, RM were transformed

and treated with the PPARc ligands GW1929 (600 nm) or

RSG (100 nm), or with dimethylsulfoxide as a control

Where indicated, the PPARc antagonist T0070907 (1 lm)

(Tocris Bioscience, Bristol, UK) or the NAMPT inhibitor

FK866 (100 nm) (Cayman Chemical, Tallinn, Estonia) were

added In other experiments, RM were treated with

GW1929 (600 nm) or dimethylsulfoxide for 24 h and then

activated into M1 macrophages by incubation with

(5 ngÆmL)1) (Promokines, Heidelberg, Germany) for 4 h or

with LPS (100 ngÆmL)1) (Sigma, Saint-Quintin Fallavier,

France) for 1 h M2 macrophages were obtained by

differ-entiating monocytes in the presence of recombinant human

IL-4 (15 ngÆmL)1) (Promokines)

Visceral adipose tissue biopsies were obtained from

consenting obese patients undergoing bariatric surgery

This study was approved by the Ethics Committee of the

University Hospital of Lille, France After removing all

fibrous materials and visible blood vessels, adipose tissue

was cut into small pieces and digested in Krebs buffer, pH

7.4, containing collagenase (1.5 mgÆmL)1; Roche

Diagnos-tic, Meylan, France) The cell suspension was filtered

through a 200-lm pore-size filter and centrifuged at 300 g

for 15 min to separate floating adipocytes The stromal

vascular fraction was pelleted, treated with erythrocyte

pH 7.4) for 10 min and filtered through meshes with a pore

size of 70 lm The stromal vascular fraction was then

sub-jected to magnetic-activated cell sorting of CD14+ cells

(Miltenyi Biotec, Paris, France) using CD14-labelled

mag-netic beads and MS columns (Miltenyi, Paris, France),

according to the manufacturer’s instructions, to yield

cytometry analysis ATM were cultured for 24 h in

endo-thelial cell basal medium, supplemented with 0.1% BSA,

before treatment with GW1929 (600 nm) or

dimethylsulfox-ide for 24 h

The CD14 negative fraction was cultured in

pre-adipo-cyte basal medium (Promocell, Heidelberg, Germany) for

24 h, then washed with NaCl⁄ Pi to remove floating cells

Adherent pre-adipocytes were then cultured in

pre-adipo-cyte growth medium (Promocell), according to the

manu-facturer’s instructions, until confluence After confluence, pre-adipocytes were cultured in pre-adipocyte differentia-tion medium (Promocell) for 72 h To complete the differ-entiation process into mature adipocytes, cells were fed every 2–3 days for 12 days with adipocyte nutrition med-ium (Promocell) At the end of the differentiation, mature adipocytes were treated with the PPARc ligand GW1929 (600 nm)

Murine bone marrow-derived macrophages were pre-pared from C57BL⁄ 6J mice Bone marrow cell suspensions were isolated by flushing the femurs and tibias with NaCl⁄ Pi and cells were cultured as previously described [51] Bone marrow-derived macrophages were treated with the PPARc ligands GW1929 (1.2 lm) and RSG (1 lm) for

24 h

RNA extraction and analysis Total cellular RNA was extracted from human macrophages using Trizol (Invitrogen, France) for RM or the RNeasy micro kit (Qiagen, Courtaboeuf, France) for ATM For Q-PCR, total RNA was reverse transcribed and cDNAs were quantified by the Q-PCR on an MX 4000 apparatus (Strata-gene) using specific primers for human visfatin (forward, GCC AGC AGG GAA TTT TGT TA-3¢; and reverse, 5¢-TGA TGT GCT GCT TCC AGT TC-3¢), mouse visfatin (forward, 5¢-TCCGGCCCGAGATGAAT-3¢; and reverse, 5¢-GTGGGTATTGTTTATAGTGAGTAACCTTGT-3¢), human CD36 (forward, 5¢-TCAGCAAATGCAAAGAAG GGAGAC-3¢; and reverse, 5¢-GGTTGACCTGCAGCCGT TTTG-3¢), mouse CD36 (forward, 5¢-GGATCTGAAATC GACCTTAAAG-3¢; and reverse, 5¢-TAGCTGGCTTGAC CAATATGTT-3¢), human FABP4 (forward, 5¢-TACTGG GCCAGGAATTTGAC-3¢; and reverse, 5¢-GTGGAAGT GACGCCTTTCAT-3¢) and human ⁄ mouse cyclophilin (for-ward, 5¢-GCA TAC GGG TCC TGG CAT CTT GTC C-3¢; and reverse, 5¢-ATG GTG ATC TTC TTG CTG GTC TTG C-3¢) Visfatin mRNA levels were subsequently normalized to those of cyclophilin

Adenovirus preparation and cell infection The recombinant adenoviruses AdGFP and AdPPARc were obtained by homologous recombination in Escherichia coliafter insertion of the cDNAs into the pAdCMV2 vector (Q.BIOgene, Illkirch, France) Viral stocks were created as previously described [52] Viral titers were determined by plaque assay on HEK 293 cells and defined as plaque-form-ing unitsÆmL)1 For the infection experiments, primary human macrophages were seeded in six-well Primaria plates

at a density of 106cells per well and viral particles were added at a multiplicity of infection of 100 for 12 h Cells were subsequently incubated for 24 h with RSG (100 nm)

or dimethylsulfoxide

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In vitro translation and EMSA

PPARc and RXRa were in vitro transcribed from the

pSG5–hPPARc and pSG5–hRXRa plasmids, respectively,

using T7 polymerase, and subsequently translated using the

transcription and translation (TNT)-coupled transcription⁄

translation system (Promega, Madison, WI, USA) Proteins

were then incubated for 10 min at room temperature in a

binding buffer (10 mm Hepes, pH 7.8, 100 mm NaCl,

contain-ing 1 lg of poly(dI-dC) and 1 lg of herrcontain-ing sperm DNA in

a total volume of 20 lL Double-stranded oligonucleotides

containing the wild-type DR1–PPRE, present at

end-labeled using T4 polynucleotide kinase and [32P]dATP[cP],

were added as a probe to the binding reaction For

compe-tition experiments, increasing amounts (5, 10, 50, 100 and

200-fold excess) of unlabeled visfatin–PPREwt (5¢-CAAT

ACAGGGCAAAGATCATGGAAG-3¢) or

visfatin–PPRE-mut (5¢-CAATACAGGAAAAAGAAAATGGAAG-3¢)

oli-gonucleotides were added to the mixture 10 min before the

DR1–visfatin–PPREwt The binding reaction was incubated

for a further 15 min at room temperature For supershift

assays, 2 lL of monoclonal mouse anti-human PPARc IgG

(Sc-7273; Santacruz Biotechnology, Heidelberg, Germany)

was added to the binding reaction DNA–protein complexes

were resolved by 6% nondenaturing PAGE in 0.25· Tris ⁄

Borate⁄ EDTA

Plasmid cloning and transient transfection

experiments

was generated by inserting six copies of the double-strand

oligonucleotides (forward, 5¢-CAATACAGGGCAAAGAT

CATGGAAG-3¢; and reverse, 5¢-CTTCCATGATCTTTG

CCCTGTATTG-3) into the pTK–pGL3 plasmid Primary

human macrophages were transfected overnight in RPMI

containing 10% human serum with reporter plasmids and

expression vectors (pSG5–empty or pSG5–hPPARc) using

expression vectors were used as an internal control of

trans-fection efficiency Subsequently, cells were incubated for an

additional 24 h in RPMI containing 2% human serum in

the presence of GW1929 (600 nm) or dimethylsulfoxide At

the end, cells were lysed, and luciferase and b-galactosidase

activities were measured on cell extracts using a luciferase

buffer (Promega)

siRNA

siRNA specific for human PBEF1 (Visfatin NAMPT), and

nonsilencing control siRNA (siScrambled) were purchased

from Dharmacon Seven-day-old human macrophages were

transfected with siRNA using the transfection reagent DharmaFECT Reagent 4 Sixteen hours after transfection, cells were incubated in the presence of GW1929 (600 nm)

or vehicle (dimethylsulfoxide) and harvested 24 h later

Protein extraction and western blot analysis Cells were washed twice with ice-cold NaCl⁄ Piand harvested

in ice-cold protein lysis buffer (RIPA) Cell homogenates were collected by centrifugation at 13 000 rpm at 4C for 30 minutes and protein concentrations were determined using the bicinchoninic acid assay (Pierce Interchim, Rockford, IL, USA) Ten micrograms of protein lysate was separated by

mem-branes (Amersham, Saclay, France) Equal loading of pro-teins was verified by Ponceau red staining Membranes were then subjected to immunodetection using rabbit polyclonal antibodies against visfatin (ab24149; Abcam, Paris, France)

or against b-actin (I-19; Santacruz Biotechnology) After incubation with a secondary peroxidase-conjugated antibody (Cell Signaling Technology, Denver, MA, USA), immunore-active bands were revealed using a chemiluminescence ECL detection kit (Amersham) and the intensity of signals was subsequently analyzed by densitometry and quantified using Quantity One software

Measure of visfatin protein secretion by ELISA Human RM were treated with the PPARc ligand GW1929 (600 nm, or with dimethylsulfoxide, for 24 h Supernatants were collected and extracellular visfatin concentrations were measured using a commercially available ELISA kit with a human visfatin (COOH-terminal) enzyme immunometric assay (Phoenix Pharmaceuticals, Karlsruhe, Germany), according to the manufacturer’s instructions

Measurement of cellular NAD content Total nicotinamide adenine dinucleotide (NADt = NAD + NADH) levels were determined in cell lysates using the

manufac-turer’s instructions (Biovision research products, Mountain View, CA, USA) Briefly, human RM, treated or not with FK866 (100 nm), infected or not with adenovirus (AdGFP, AdPPARc) and transfected or not with siRNA (siScrambled, siVisfatin) were treated with the PPARc ligands GW1929 (600 nm) or RSG (100 nm), or with dimethylsulfoxide, for

24 h Cells were lysed in NAD+extraction buffer after wash-ing three times with ice-cold NaCl⁄ Pi The NAD⁄ NADH

were normalized to protein content The results are expressed

as a percentage, with the control unstimulated cells being expressed as 100% All assays were performed in triplicate in

at least three independent experiments

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