Abstract

Ketohexokinase (KHK) is the first and rate-limiting enzyme of fructose metabolism. Expression of the two alternatively spliced KHK isoforms, KHK-A and KHK-C, is tissue-specific and KHK-C is predominantly expressed in liver, kidney and intestine and responsible for the fructose-catabolizing function. While KHK isoform choice has been linked to the development of disorders such as obesity, diabetes, cardiovascular disease and cancer, little is known about the regulation of total KHK expression. In the present study, we investigated how hypoxic signaling influences fructose metabolism in the liver. Hypoxia or von Hippel-Lindau (VHL) tumor suppressor loss leads to the stabilization of hypoxia-inducible factors alpha (HIF-1α and HIF-2α) and the activation of their signaling to mediate adaptive responses. By studying liver-specific Vhl, Vhl/Hif1a, and Vhl/Epas1 knockout mice, we found that KHK expression is suppressed by HIF-2α (encoded by Epas1) but not by HIF-1α signaling on mRNA and protein levels. Reduced KHK levels were accompanied by downregulation of aldolase B (ALDOB) in the livers of Vhl and Vhl/Hif1a knockout mice, further indicating inhibited fructose metabolism. HIF-1α and HIF-2α have both overlapping and distinct target genes but are differentially regulated depending on the cell type and physiologic or pathologic conditions. HIF-2α activation augments peroxisome degradation in mammalian cells by pexophagy and thereby changes lipid composition reminiscent of peroxisomal disorders. We further demonstrated that fructose metabolism is negatively regulated by peroxisome-deficiency in a Pex2 knockout Zellweger mouse model, which lacks functional peroxisomes and is characterized by widespread metabolic dysfunction. Repression of fructolytic genes in Pex2 knockout mice appeared to be independent of PPARα signaling and nutritional status. Interestingly, our results demonstrate that both HIF-2α and peroxisome-deficiency result in downregulation of Khk independent of splicing as both isoforms, Khka as well as Khkc, are significantly downregulated. Hence, our study offers new and unexpected insights into the general regulation of KHK, and therefore fructolysis. We revealed a novel regulatory function of HIF-2α, suggesting that HIF-1α and HIF-2α have tissue-specific opposing roles in the regulation of Khk expression, isoform choice and fructolysis. In addition, we discovered a previously unknown function of peroxisomes in the regulation of fructose metabolism.

Highlights

  • Dietary fructose is a monosaccharide naturally found in fruits and vegetables and is a major component of commonly used sweeteners like sucrose and high-fructose corn syrup (Jensen et al, 2018)

  • Treatment slightly decreased KHK and aldolase B (ALDOB) protein levels in control mice, but no further decrease could be observed in Vhl−/− livers (Figure 7H). These results suggest that pharmacological peroxisome proliferator-activated receptor α (PPARα) activation exhibits at most moderate effects on KHK and ALDOB mRNA and protein levels, which appear to depend on age, while hypoxia-inducible factor (HIF)-2α signaling and peroxisome deficiency are strong repressors of fructolytic gene expression

  • The main finding of this study is that in organs with high fructolytic activity total Khk and associated Khkc and Khka expression is negatively regulated by HIF-2α signaling and by lack of peroxisomal metabolism

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Summary

Introduction

Dietary fructose is a monosaccharide naturally found in fruits and vegetables and is a major component of commonly used sweeteners like sucrose and high-fructose corn syrup (Jensen et al, 2018). SLC2A5 has high specificity for fructose and is mainly expressed at the apical membrane of epithelial intestinal cells for fructose absorption, followed by renal proximal tubule cells for reabsorption (Douard and Ferraris, 2008). While SLC2A2 expression is highest in the liver, the primary organ metabolizing ingested fructose, basolateral membranes of epithelial intestinal and kidney cells as well as pancreatic β-cells express considerable levels (Douard and Ferraris, 2013; Thorens, 2015). Ketohexokinase (KHK), or fructokinase, is the major fructose-metabolizing enzyme that catalyzes the conversion of fructose and ATP into fructose-1-phosphate (F1P) and ADP, respectively (Hayward and Bonthron, 1998). Affected individuals cannot phosphorylate fructose, so it rises to high levels in the serum and is excreted in the urine. In hereditary fructose intolerance (HFI; OMIM 229600), lack of ALDOB

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