Neuron‐specific knockout of FXR attenuates the neurological complications of chronic liver disease

Hepatic encephalopathy (HE) describes the neurological deficits that result from liver impairment. Liver disease is associated with an increase of circulating bile acids that can cross the blood brain barrier and activate FXR receptors in neurons. We have previously demonstrated that aberrant bile acid signaling via activation of neuronal FXR contributes to HE pathogenesis in rodent models of acute liver failure. However, a role for FXR‐mediated bile acid signaling in HE due to chronic liver cirrhosis is undefined. Methods Neuron‐specific FXR knockout mice were generated by crossing Floxed FXR mice (FXR fl ) with SNAP‐25 cre recombinase mice. The resulting mice were designated FXR Δneu . C57Bl/6 (WT), FXR fl , and FXR Δneu were treated with carbon tetrachloride (CCl4; 1 ml/kg) by oral gavage twice per week for 12 weeks. Neurobehavioral indices and neuromuscular deficits were assessed by open field test, rotarod, grip strength test and gait analysis. After 12 weeks, tissue was collected and liver damage was assessed by serum chemistry and H&E staining. Total bile acid content was assessed in the cortex and cerebellum using colorimetric assays. The expression of ASBT, FXR, and its downstream effector SHP was assessed by qPCR and immunofluorescence. Microglia activation was assessed by Iba1 immunofluorescence. The expression of proinflammatory cytokines were assessed by qPCR and EIA. In parallel, total bile acids, ASBT and FXR expression were assessed in brain tissue from cirrhotic patients with HE, compared to cirrhotics without HE and age‐ and gender‐matched controls that had been collected and banked by the Australian Brain Bank Network. Results Total bile acid content was elevated in the cortex and cerebellum in CCl4‐treated WT mice and in cirrhotic patients with HE, compared to cirrhotics without HE and non‐liver impaired controls. Furthermore, ASBT, FXR and SHP expression were increased in the frontal cortex of mice and humans with HE, but not in non‐HE control samples. WT and FXR fl mice treated with CCl4 had significant deficits observed in every neurobehavioral and neuromuscular test performed, as well as marked microglia activation and increased proinflammatory cytokine expression compared to vehicle‐treated mice. These neurological deficits and neuroinflammation were attenuated in FXR Δneu mice after CCl4 treatment, even though liver damage was comparable in all genotypes of mice used. Conclusions Taken together, these data indicate that neuronal expression of FXR plays an important role in the development of HE. Specific targeting of FXR activation in the brain may prove fruitful in the development of novel therapeutics for the management of HE. Support or Funding Information This study was funded by NIH R01 awards (DK082435 and DK112803) and a VA Merit award (BX002638) from the United States Department of Veterans Affairs Biomedical Laboratory Research and Development Service to Dr. DeMorrow. This study was also funded by a VA Career Development award (BX003486) from the United States Department of Veterans Affairs Biomedical Laboratory Research and Development Service to Dr. McMillin. This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal .