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1From the Centre for Endocrine and Diabetes Sciences, School of Medicine, Cardiff University, United Kingdom.
| Abstract |
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METHODS. Activating mutant TSHR (TSHR*) or wild-type (WT) was introduced into human orbital preadipocytes using retroviral vectors. Their proliferation (Coulter counting), basal cAMP accumulation (radioimmunoassay), and spontaneous and peroxisome proliferator-activated receptor (PPAR
)-induced adipogenesis (quantitative oil red O staining) were assessed and compared with those of nonmodified cells. QRT-PCR was used to measure transcripts of CCAT/enhancer binding protein (C/EBP)ß, PPAR
, and lipoprotein lipase (LPL; early, intermediate, and late markers of adipogenesis) and for uncoupling protein (UCP)-1 (brown adipose tissue [BAT]).
RESULTS. Expression of TSHR* significantly inhibited the proliferation of preadipocytes and produced an increase in unstimulated cAMP of 200% to 600%. Basal lipid levels were significantly increased in TSHR* (127%275%) compared with nonmodified (100%) or WT-expressing (104%187%) cells. This was accompanied by 2- to 10-fold increases in early-intermediate markers and UCP-1 transcripts (2- to 8-fold); LPL was at the limit of detection. In nonmodified cells, adipogenesis produced significant increases in transcripts of all markers, including LPL (approximately 30-fold). This was not the case in TSHR*-expressing cells, which also displayed 67% to 84% reductions in lipid levels.
CONCLUSIONS. TSHR activation stimulates early differentiation (favoring BAT formation?) but renders preadipocytes refractory to PPAR
-induced adipogenesis. In neither case did lipid-containing vacuoles accumulate, suggesting that terminal stages of differentiation were inhibited.
The receptor can also be activated by gain-of-function mutations, with somatic changes responsible for toxic adenoma and germline mutations causing familial hyperthyroidism.1 Of interest, two newborns harboring different activating germline TSHR mutations, L629F and M453T, displayed proptosis.9 10 We have exploited this activation mechanism to establish an in vitro model to investigate the resultant biological effects, beginning with adipose tissue, the site of TSHR expression in the orbit.
| Methods |
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Six tissue samples were collected, three from GO patients (undergoing decompression surgery) and three from patients free of GO and thyroid autoimmunity (undergoing blepharoplasty with fat pad excision).
Preadipocytes were obtained from explants of the adipose tissues, cultured in DMEM/F12 10% FCS (complete medium). Adipogenesis was induced in confluent cells by replacement with medium having reduced FCS and containing a range of hormones and PPAR
agonists (differentiation medium), for 10 days, as previously described.11
Activating mutant TSHR, L629F and M453T, and wild-type (WT) were introduced using retroviral vectors previously produced in our laboratory.12 Geneticin selection resulted in mixed populations stably expressing the various TSHRs, all as previously described.12
Effect on Proliferation and cAMP Levels
WT, TSHR*-expressing, and nonmodified preadipocytes were plated at 5 x 104/well in 12-well plates. They were counted with a Coulter particle counter 3 and 5 days after plating; the difference indicated proliferation in 48 hours. Results were expressed as total increased cell counts or as population doubling time (PDT).
The same plating conditions were used for cAMP estimates, but, once attached, the cells were incubated for 4 hours in medium containing 104 M isobutylmethylxanthine (IBMX) with no further addition (basal conditions) plus 105 M forskolin or 10 mU/mL bovine TSH. Cyclic AMP was extracted in 0.1 M HCl and measured using an in-house radioimmunoassay capable of detecting femtogram quantities of the second messenger, as previously described.13 Coulter counting of adjacent wells provided an accurate cell number for results to be expressed as picomole cAMP per 104 cells.
Effect on Spontaneous and PPAR
-Induced Adipogenesis
Various cell populations (in 12-well plates) were examined in complete and differentiation medium. Microscopic examination provided a means of determining whether morphologic changes, e.g., rounding up of cells or acquisition of lipid-filled droplets, had occurred. In addition, the cells were subjected to oil red O staining, followed by extraction of the absorbed dye with 100% isopropanol and measurement of the OD490. Coulter counting of adjacent wells provided an accurate cell number for standardization of OD values.
QRT-PCR of Transcripts for Early, Intermediate, and Late Adipogenesis and BAT
The various cell populations were plated in six-well plates in complete or differentiation medium. Ten days later, RNA was extracted and reverse transcribed, and transcript copy numbers for C/EBPß, PPAR
, LPL, and UCP-1 were measured using Sybr green and a light cycler (MX3000; Stratagene, La Jolla, CA). Primer details are provided in Table 1 .
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Statistical Analysis
Means were compared nonparametrically by Kruskal-Wallis, post hoc by Dunns multiple comparison test, and parametrically by ANOVA with post hoc Tukey HSD.
| Results |
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, which activates adenylate cyclase and produces increased cAMP on ligand binding or in the absence of ligand for gain-of-function mutants such as M453T and L629F.1 To investigate whether the TSHR is functional and similarly coupled in preadipocytes, we measured TSH-induced cAMP, whereas unstimulated cAMP levels would indicate whether the gain-of-function mutants were active. Forskolin provided a positive control and in all cases induced a robust increase in cAMP corresponding to at least a 10-fold increase compared with basal.
As shown in Figures 2A and 2B , the nonmodified cells responded minimally (twofold increase) to TSH, in keeping with the very low proportion of these cells expressing the receptor. In contrast, TSH induced a 4- to 16-fold increase in cells expressing the WT or mutant forms of TSHR, indicating that the receptor was coupled to Gs
in these cells. Furthermore, unstimulated (basal) cAMP was significantly (P < 0.05, GO; P < 0.01 non-GO) increased in the L629F- and M453T-expressing cells compared with the nonmodified or WT, indicating that the gain-of-function mutants were active in preadipocytes from normal orbits and patients with GO.
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TSHR Activation Induces Morphologic Changes in Preadipocytes
In complete medium, orbital preadipocytes expressing mutant TSHR had a more rounded appearance than their WT-expressing or nonmodified counterparts, but no obvious lipid vacuoles were observed, either microscopically or after oil red O staining. A representative example is shown in Figure 4 .
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-Induced Adipogenesis
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agonist. To investigate further, the transcript copy number of genes whose expression is upregulated during adipogenesis was calculated.
In nonmodified preadipocytes, PPAR
-induced adipogenesis (visible oil red Opositive lipid droplets) was accompanied by an increase in all the markers of differentiation tested compared with the equivalent transcript copy number obtained in these cells in complete medium.
In the TSHR*-expressing cells, no PPAR
-induced adipogenesis was apparent, and the transcript copy number of the differentiation markers was not increased. In fact, in some instances it was reduced compared with the same cells in complete medium.
When comparing the nonmodified cells and the TSHR*-expressing cells, all in complete medium, transcript copy numbers for markers of early to intermediate differentiation and brown adipose tissue formation, but not those for the terminal stages of adipogenesis, were upregulated, as summarized in Table 2 . A representative example of the individual Ct values obtained is shown in Table 3 .
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| Discussion |
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A heterogeneous population of cells migrates from the explants, including fibroblast-like preadipocytes and cells at various stages of fat maturation. Cells containing lipid vacuoles could be fibroblast-like preadipocytes undergoing adipogenesis or cells at various stages of fat maturation in the process of de-differentiating. Gesta et al.14 have indicated that de-differentiation occurs within the first 48 hours of culture. We observed cells close to the explants with lipid-filled droplets that persisted for several months. Only detachment or removal of the explant reduced the lipid droplets, indicating the production of pro-adipogenic signals, both soluble and through cellcell contact, by mature fat.
Our subsequent experiments indicated that TSHR activation stimulates the early stages of adipogenesis but inhibits the terminal stages of differentiation. The absence of lipid-filled droplets, combined with increased cellular lipid content, suggests that lipolysis is upregulated or that the cytoskeletal changes necessary for droplet formation have been inhibited. The fact that lipoprotein lipase transcripts remain at the limit of detection in cells expressing TSHR* favors the latter mechanism. The results agree with earlier reports of cAMP elevation rapidly reducing a suppressor of adipogenesis, Wnt,15 thereby promoting differentiation. In contrast, prolonged elevation of cAMP by pharmacologic agents reduced the accumulation of lipids by decreasing key lipogenic enzymes rather than increasing lipolysis.16
TSHR activation also seems to favor the development of brown adipose tissue. Although elevated UCP-1 transcripts are a feature of human preadipocytes exposed to PPAR
agonists,17 we observed an increase in UCP-1 copies in the TSHR*-expressing cells, even in complete medium (basal conditions). It is possible that this feature may be restricted to orbital preadipocytes, a depot having many similarities with brown adipose tissue such as selective expansion (along with intrascapular fat) in mice overexpressing adiponectin.18
We opted to use gain-of-function mutants of the TSHR as an activation mechanism rather than adding the pathologic ligands TSAB. At the time this study began, only patient sera containing heterogeneous mixes of TSAB were available because monoclonal TSABs have only recently been developed.19 20 21 22 Furthermore, our previous experiences demonstrated that the vectors transduced a physiological level of TSHR expression because we were unable to distinguish endogenous rat TSHR from transduced human TSHR using flow cytometry in a rat thyroid cell line.12 The model also has the advantage of generating free
and ß/
subunits of the G protein, unlike an earlier study23 in which constitutively active Gs
mutants were expressed in the murine 3T3L1 cell line There was no effect on proliferation; basal cAMP or rates of adipogenesis compared with nonmodified cells were not examined.
Recent studies have reported that the activation of CREB (by phosphorylation) is necessary and sufficient to induce adipogenesis in the 3T3L1 preadipocyte cell line.24 CREB can be activated by the cAMP/PKA route, though there are other activation mechanisms. In the FRTL5 thyroid cell line, we observed increased phosphorylated CREB (p-CREB) in cells expressing TSHR* compared with the WT or nonmodified cells.25 Thus, we expected that the human preadipocytes expressing the same gain-of-function mutant TSHR would also have increased p-CREB and should thus have exhibited spontaneous adipogenesis. However preliminary experiments indicate that this is not the case, with threefold to fourfold higher levels of pCREB present in WT compared with activating mutant TSHR-expressing cells. This is in agreement with the work of Brunetti et al.,26 who demonstrated increased adenylate cyclase but reduced pCREB in toxic adenoma (somatic TSHR*) compared with adjacent healthy thyroid tissue. We assume that the discrepancy between cAMP and pCREB is the consequence of upregulation of counterregulatory mechanismse.g., the inducible cAMP early repressor27 induced by the higher levels of cAMP present in the L629F- and M453T-transduced preadipocytes. The difference illustrates that though they provide useful in vitro models, rodent preadipocyte cell lines do not replicate all aspects of human adipogenesis.
Although we have investigated primary preadipocytes, our model does not faithfully reproduce TSHR expression during adipogenesis. Haraguchi et al.28 demonstrated that the receptor is upregulated and reaches a maximum at around day 9 of an adipogenesis protocol, including insulin, dexamethasone, and a phosphodiesterase inhibitor. Transcript levels then declined. Our vectors are driven by a viral promoter so that receptor expression is permanently "ON. " We are generating inducible retroviral vectors and siRNA to permit the modulation of activating TSHR expression and to mimic more closely that occurring during adipogenesis.
Apart from this shortcoming, our model has addressed how TSHR activation might affect just one of the mechanisms operating to increase the orbital volume in GO. We are aware that not all GO patients have circulating TSABs and that other processes may be in operation. Furthermore, the TSHR is expressed on only a small proportion of orbital fibroblasts.
Increased cAMP in preadipocytes has been associated with the production of an adipogenic factor, a putative endogenous PPAR
agonist.29 If this were the case, TSHR activation could have an indirect effect on adipogenesis by elaborating an adipogenic factor having paracrine effects. Experiments are under way using conditioned media from our transduced cells to investigate their proadipogenic activity on primary preadipocytes from various fat depots, including the orbit.
In conclusion, we have demonstrated that TSHR activation stimulates early differentiation and may favor the formation of brown adipose tissue. In contrast, TSHR activation renders preadipocytes refractory to PPAR
-induced adipogenesis. In neither case do lipid-containing vacuoles accumulate, suggesting that terminal stages of differentiation have been inhibited.
| Acknowledgements |
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| Footnotes |
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3 Present affiliation: Medizinische Klinik III, Universitaet Leipzig, Germany. ![]()
Supported by grants from The Wellcome Trust and the Wales Office for Research and Development.
Submitted for publication June 2, 2006; revised July 26 and August 21, 2006; accepted October 10, 2006.
Disclosure: L. Zhang, None; G. Baker, None; D. Janus, None; C.A. Paddon, None; D. Fuhrer, None; M. Ludgate, None
The publication costs of this article were defrayed in part by page charge payment. This article must therefore be marked "advertisement" in accordance with 18 U.S.C.
1734 solely to indicate this fact.
Corresponding author: Marian Ludgate, Centre for Endocrine and Diabetes Sciences, School of Medicine, Cardiff University, Main Building, Heath Park, Cardiff CF14 4XN, UK; ludgate{at}cf.ac.uk.
| References |
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in thyroid eye disease: contra-indication for thiazolidenedione use?. J Clin Endocrinol Metab. 2003;88:5559.
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