In this work, we investigated the link between IBD and BA luminal absorption, by testing the effect of the pro-inflammatory cytokines TNF-α and IFN-γ and of the SCFA BT upon the apical uptake of 3H-TA by Caco-2 cells.
Ileal ASBT is the main responsible for the intestinal absorption of bile acids and decreased ASBT expression has been described in both pre-clinical models of IBD (murine, canine and rabbit models) and human IBD [16, 25]. Indeed, in the intestine, about 95% of luminal BA are actively reabsorbed in the distal ileum by the apical sodium-dependent bile acid transporter (ASBT, also known as SLC10A2). The other 5% BAs are transported into the colon where they are metabolized (deconjugated and dihydroxylated) by microbiota; part of them is returned to the liver while the others are excreted with feces. Although ileal ASBT constitutes the major route of absorption for most conjugated bile acids such as taurocholic acid, passive absorption present throughout the small intestine is the main route for unconjugated bile acid reabsorption [16, 26, 27]. Mechanistically, ASBT is electrogenic, requiring the cotransport of two Na+ ions together with a BA molecule, and the driving force is the inwardly directed Na+ gradient, which is maintained by both the basolateral Na+/K+-ATPase and the negative intracellular potential. ASBT preferentially transports conjugated BA compared with unconjugated BA [27]. Therefore, ASBT activity was assessed by the measurement of Na+-dependent 3H-taurocholic acid (3H-TC) uptake.
Uptake of 3H-TC uptake by Caco-2 cells was found to be time- and concentration-dependent. However, despite the fact that TC is a good substrate for ASBT [16, 26, 27] and that quantification of Na+-dependent uptake of 3H-TC by Caco-2 cells is an established cell model for evaluation of ASBT activity, we verified that the Na+-dependent component plays a minor role in 3H-TC uptake by Caco-2 cells. This observation stands in contrast to previous studies showing that 3H-TC uptake by Caco-2 cells is mainly Na+-dependent [22, 28]. We have no explanation for this seemingly lower Na+-dependency of 3H-TC uptake in our experiments. However, it is worth to note that the level of ASBT expression in Caco-2 cells appears to be low and not consistent [28, 29] and that several works evaluate ASBT activity by quantifying Na+-dependent 3H-TC uptake by Caco-2 cells, but no information as to the fraction of uptake that is Na+-dependent is given (eg. [30, 31]). The observation that Na+-independent 3H-TC uptake is specifically inhibited by DC and CDC argues against the possibility of Na+-independent uptake occurring via passive absorption, although a linear correlation between 3H-TC concentration and Na+-independent uptake was found, suggesting the involvement of a non-saturable mechanism. Further, the observation that the Km for total uptake is higher than the Km of Na+-dependent uptake suggests a low affinity of the Na+-independent mechanism involved in 3H-TC uptake. Although the general consensus is that ileal active transport, ABST-mediated, is the major route for conjugated BA uptake, passive or facilitative absorption is also present down the length of the small intestine. Several studies have shown that the Na+-independent transporter OATP1A2 is expressed at the apical brush border membrane of human small intestinal epithelial cells and transports BA as well as a variety of drugs [32, 33] and a comparison between the absolute protein expression levels of 28 drug-related transporters in Caco-2 cell monolayers concluded that the expression levels of OATP1A2 and ASBT were similarly low [34]. So, it is possible that OATP1A2 is the responsible for most of 3H-TC uptake by Caco-2 cells.
The effect of IBD on 3H-TC uptake was investigated by testing the effect of TNF-α and IFN-γ on 3H-TC uptake and ASBT mRNA expression levels. We verified that both TNF-α and IFN-γ concentration-dependently reduced total 3H-TC uptake. We were also able to verify that both cytokines reduced Na+-independent uptake, whereas Na+-dependent uptake was inhibited by TNF-α only. Previous studies have shown that ASBT expression is decreased by cytokines contributing to the pathophysiology of IBD, namely IL-1β [35–37] and TNF-α [35]. These cytokines repress ASBT expression by inducing upregulation, phosphorylation, and nuclear translocation of c-fos, which then represses ASBT promoter activity via AP-1 [36, 38]. In addition to transcriptional regulation, proteosomal-mediated degradation of ASBT is stimulated by cytokines such as IL-1β [37]. However, the effect of proinflammatory cytokines on ASBT activity was not evaluated in these previous studies. So, the present report shows for the first time that TNF-α and IFN-γ decrease 3H-TC uptake by a human intestinal epithelial cell line, and that TNF-α inhibits Na+-dependent (probably ASBT-mediated) transporter activity. Of note, the decrease in Na+-dependent 3H-TC induced by TNF-α is not related with a decrease in ASBT expression levels; rather, an increase in ASBT mRNA levels was observed in response to TNF-α (and also IFN-γ). In a previous report, TNF-α was found to downregulate ASBT gene expression in Caco-2 cells [35]. This difference may be related to the fact that the exposure time to TNF-α was almost the double (40h) in [35].
By using specific pharmacological inhibitors of PI3K (LY294002) and JAK/STAT1 (fludorabine), we could conclude that the inhibitory effect of TNF-α and IFN-γ upon 3H-TC apical total and Na+-independent uptake is mediated by these intracellular signaling pathways. Interestingly, repression of ASBT expression by TNF-α and IL-1β was previously found to be mediated by the PI3K signaling [35] and stimulation of ubiquitin-proteasome degradation of ASBT by IL-1β was previously described to be due to JNK-regulated serine/threonine phosphorylation of ASBT protein [37]. In the present report, we thus describe that the inhibitory effect of inflammatory cytokines on total and Na+-independent (and therefore, ASBT-independent) 3H-TC uptake is similarly PI3K- and JAK (JAK2)-mediated.
The SCFA BT is a product of microbiota-mediated fermentation of dietary fibers with anti-inflammatory effects. This compound modulates various points in the inflammatory process in colonic epithelial cells and has also direct effects in intestinal immune cells (T and B cells, macrophages, neutrophils and dendritic cells), not only via long-recognized direct inhibitory effects on cell division, but also via modulation of cell signaling, epigenetic regulation and metabolism [39]. BT regulates inflammation by acting through two distinct mechanisms: (1) it interacts with cell membrane G protein-coupled receptors (GPR41, GPR43 and GPR109A) expressed in gut epithelium and immune cells, regulating downstream cell signal transduction mechanisms such as NF-κB pathway, MAPK and Ca2+, and (2) after entering colonic epithelial cells through transport proteins (such as MCT1 and SMCT1), it inhibits histone deacetylase [39–41]. Interestingly, a defect in BT epithelial uptake was described in IBD [19, 20], resulting in higher luminal concentrations of this compound. So, we decided to evaluate if BT interferes with BA uptake, as a mechanism contributing to its anti-inflammatory effect.
We tested the effect of increasing doses (in the mM range) of butyrate. High concentrations (in the mM range) of BT in the colonic lumen may be attained, for example, after digestion of a dietary fiber-containing meal (the concentrations of these fatty acids in the lumen may reach 70–130 mM, with 20–30% being BT) [42, 43]. In contrast, a low concentration (in the µM range) of BT may be attained in the intermeal period or at the bottom of colonic crypts[17].
We verified that lower levels of BT (0-5-5 mM) increased 3H-TC uptake by 10–20% and that, in contrast, higher levels of BT (10 mM) showed an inhibitory action on 3H-TC uptake. BT does not interfere with Na+-dependent uptake nor changes ASBT expression levels; rather, it negatively affects Na+-independent 3H-TC uptake. The increase in 3H-TC uptake caused by BT (0.5-5 mM) might contribute to the anti-inflammatory effect of this SCFA, because luminal BA promote intestinal inflammation [3]. In contrast, inhibition of 3H-TC by BT (10 mM) may contribute to higher deleterious luminal levels of BA. Moreover, BT (10 mM) was able to potentiate the inhibitory effect of IFN-γ upon 3H-TC uptake, which can also contribute to higher luminal BA levels. Overall, we verified that BT (in high concentrations) causes an inhibition of 3H-TC uptake and possesses an additive effect with IFN-γ in reducing 3H-TC uptake. These results thus suggest that, both in the absence and presence of intestinal inflammation, high luminal BT inhibits the intestinal epithelial cell uptake of BA, which may contribute to higher luminal levels of these compounds.
Traditionally, patients with IBS were told to increase dietary fiber intake, but several randomized controlled trials have now shown that “Fermentable Oligosaccharides, Disaccharides, Monosaccharides And Polyols” (FODMAP) restriction leads to an improvement in IBS symptoms, compared with habitual diet [44]. Fermentation of these fibers leads to the production of BT. Our results suggest that the inhibitory effect of BT on BA colonic epithelial uptake, resulting in higher luminal levels of these compounds, may contribute to the link between BA and IBD.
In conclusion, this works shows that the proinflammatory cytokines TNF-α and IFN-γ inhibit Na+-independent, non-ASCT-mediated 3H-TC uptake by Caco-2 cells, which results in higher luminal levels of BA. The inhibitory effect of these cytokines on 3H-TC uptake is PI3K- and JAK/STAT1-mediated. Moreover, the SCFA BT was also found to inhibit 3H-TC uptake at high but physiologic concentrations and to possess an additive effect with IFN-γ in reducing 3H-TC uptake. So, an interaction between BT and BA appears to exist in IBD, that may participate in the link between dietary fiber intake and IBD.