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Activation of Carbohydrate Response Element–Binding Protein by Ethanol
  1. Suthat Liangpunsakul, MD, MPH*†,
  2. Ruth A. Ross, BS*,
  3. David W. Crabb, MD*
  1. From the *Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine; and †Roudebush Veterans Administration Medical Center, Indiana University School of Medicine, Indianapolis, IN.
  1. Received August 11, 2012, and in revised form October 22, 2012.
  2. Accepted for publication October 27, 2012.
  3. Reprints: Suthat Liangpunsakul, MD, MPH, 550 N University Blvd, UH 4100, Division of Gastroenterology and Hepatology, Indianapolis, IN 46202. E-mail: sliangpu{at}
  4. This study is supported by Veterans Administration Young Investigator Award/Indiana Institute for Medical Research, K08 AA016570 from the NIH/NIAAA, Veterans Affair Administration Merit Review Award (1I01CX000361-01A1); Central Society for Clinical Research Career development award, Research Support Fund Grant (to S.L.); and The Indiana Clinical and Translational Sciences Institute (grant RR 02576) from the National Institutes of Health, National Center for Research Resources.


Objective Carbohydrate response element–binding protein (ChREBP) is a transcription factor involved in hepatic lipogenesis. Its function is in part under the control of AMP-activated protein kinase (AMPK) and protein phosphatase 2A (PP2A). Given known effects of ethanol on AMPK and PP2A, it is plausible that ethanol might enhance fatty acid synthesis by increasing the activity of ChREBP. We hypothesized that another potential pathway of ethanol-induced hepatic steatosis is mediated by activation of ChREBP.

Methods The effects of ethanol on ChREBP were assessed in hepatoma cells and in C57BL/6J mice fed with the Lieber-DeCarli diet.

Results When the cells were exposed to ethanol (50 mM) for 24 hours, the activity of a liver pyruvate kinase (LPK) promoter–luciferase reporter was increased by ∼4-fold. Ethanol feeding of mice resulted in the translocation of ChREBP from cytosol to the nucleus. Protein phosphatase 2A activity was increased in the liver of ethanol-fed mice by 22%. We found no difference in the levels of hepatic Xu-5-P between ethanol-fed mice and controls. Transfection of a constitutively active AMPK expression plasmid suppressed the basal activity of the LPK luciferase reporter and abolished the effect of ethanol on the reporter activity. However, transfection of rat hepatoma cells with a dominant-negative AMPK expression plasmid induced basal LPK luciferase activity by only ∼20%. The effect of ethanol on ChREBP was attenuated in the presence of okadaic acid, an inhibitor of PP2A.

Conclusions The effects of ethanol on AMPK and PP2A may result in activation of ChREBP, providing another potential mechanism for ethanol-induced hepatic steatosis. However, additional okadaic acid–insensitive effects appear to be important as well.

Key Words
  • ChREBP
  • ethanol
  • AMPK
  • protein phosphatase 2A

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