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Mice Lacking Thioredoxin-interacting Protein Provide Evidence
Linking Cellular Redox State to Appropriate Response to
Nutritional Signals*
Received for publication, February 5, 2004, and in revised form, March 24, 2004
Published, JBC Papers in Press, March 26, 2004, DOI 10.1074/jbc. M401280200
To Yuen Hui‡, Sonal S. Sheth§, J. Matthew Diffley‡, Douglas W. Potter‡, Aldons J. Lusis§,
Alan D. Attie¶, and Roger A. Davis‡储
From the ‡Mammalian Cell and Molecular Biology Laboratory, Department of Biology, Molecular Biology Institute and
Heart Institute, San Diego State University, San Diego, California 92182, §Molecular Biology Institute and Department
of Medicine, Microbiology and Human Genetics, University of California, Los Angeles, California 90095, and
¶Department of Biochemistry, University of Wisconsin, Madison, Wisconsin 53706
Thioredoxin-interacting protein (Txnip) is a ubiqui-
tous protein that binds with high affinity to thioredoxin
and inhibits its ability to reduce sulfhydryl groups via
NADPH oxidation. HcB-19 mice contain a nonsense mu-
tation in Txnip that eliminates its expression. Unlike
normal animals, HcB-19 mice have ⬃3-fold increase in
insulin levels when fasted. The C-peptide/insulin ratio is
normal, suggesting that the hyperinsulinemia is due to
increased insulin secretion. Fasted HcB-19 mice are hy-
poglycemic, hypertriglyceridemic, and have higher than
normal levels of ketone bodies. Ablation of pancreatic

-cells with streptozotocin completely blocks the fast-
ing-induced hypoglycemia/hypertriglyceridemia, sug-
gesting that these abnormalities are due to excess insu-
lin secretion. This is supported by increased hepatic
mRNA levels of the insulin-inducible, lipogenic tran-
scription factor sterol-responsive element-binding pro-
tein-1c and two of its targets, acetyl-CoA carboxylase
and fatty acid synthase. During a prolonged fast, the
hyperinsulinemia up-regulates lipogenesis but fails to
down-regulate hepatic phosphoenolpyruvate carboxy-
kinase mRNA expression. Hepatic ratios of reduced:oxi-
dized glutathione, established regulators of gluconeo-
genic/glycolytic/lipogenic enzymes, were elevated 30%
in HcB-19 mice, suggesting a loss of Txnip-enhanced
sulfhydryl reduction. The altered hepatic enzymatic
profiles of HcB-19 mice divert phosphoenolpyruvate to
glyceroneogenesis and lipogenesis rather than glucone-
ogenesis. Our findings implicate Txnip-modulated sulf-
hydryl redox as a central regulator of insulin secretion
in

-cells and regulation of many of the branch-points of
gluconeogenesis/glycolysis/lipogenesis.
The liver plays a central role in controlling the flow of nutri-
ents to and from peripheral tissues. The flux of carbon units
through hepatic pathways of lipid and carbohydrate metabo-
lism are rapidly changed in response to nutrition. In the tran-
sition from the fed to the fasted state, hepatocytes switch from
being primarily glycolytic and lipogenic to being gluconeogenic
and ketogenic. This occurs in response to a drop in blood insulin
and to a lesser degree, an increase in glucagon levels.
Lipids are exported by the liver in the form of triglyceride-
rich very low density lipoprotein (VLDL)
1
particles. Depending
on the metabolic state, there are two major sources of free fatty
acids that are channeled into hepatic triglyceride production.
In the fed state, hepatocytes up-regulate the expression of
glycolytic and lipogenic enzymes, primarily by increasing the
expression and activation of a master regulator, the transcrip-
tion factor SREBP-1c (1). This process converts carbohydrate
into fatty acids, which are then esterified to form triglycerides,
the major core lipid secreted by the liver as VLDL. In the fasted
state, adipose tissue releases free fatty acids from triglyceride
stores because insulin levels drop below a threshold required to
repress lipolysis and also because of glucagon action. Although
the liver does not actively synthesize fatty acids under fasting
conditions, it retains the ability to esterify adipose tissue-de-
rived free fatty acids and to export VLDL particles. As much as
50% of fatty acids taken up by the liver during fasting are
eventually released as VLDL triglycerides (2). Indeed, in some
animal species (e.g. ponies), prolonged fasting leads to hyper-
triglyceridemia (3).
Fasting leads to enhanced gluconeogenesis by the liver. This
is largely due to an increase in the expression of key gluconeo-
genic enzymes, phosphoenolpyruvate carboxykinase (PEPCK)
(4), fructose-1,6-bisphosphatase (FBPase) (5), and glucose-6-
phosphatase (G6Pase) (6). Thus, there is usually an inverse
relationship between gluconeogenesis and lipogenesis in the
liver (2, 6, 7).
Hypertriglyceridemia is one of the most common lipid disor-
ders in the human population. It is usually associated with
obesity, insulin resistance, and diabetes (8, 9) but is also ob-
served in people without these metabolic disorders (10, 11).
There is still a dearth of knowledge about the key genes that
contribute to hypertriglyceridemia. However, in the majority of
cases, excess triglycerides are derived from overproduction
rather than defective catabolism of VLDL (8, 9).
The HcB-19 mouse is a variant of the C3H strain that was
* This project was supported by National Institutes of Health Grant
HL51648 (to R. A. D.) and American Heart Association Scientist Devel-
opment Award 0330109N (to T. Y. H.). The costs of publication of this
article were defrayed in part by the payment of page charges. This
article must therefore be hereby marked “advertisement” in accordance
with 18 U.S.C. Section 1734 solely to indicate this fact.
储To whom correspondence should be addressed: Mammalian Cell and
Molecular Biology Laboratory, Life Sciences Bldg. LS307, 5500 Cam-
panile Dr., San Diego State University, San Diego, CA 92182-4614. Tel.:
619-594-7936. Fax: 619-594-7937; E-mail: rdavis@sunstroke.sdsu.
edu.
1
The abbreviations used are: VLDL, very low density lipoproteins;
SREBP, sterol-responsive element-binding protein; FAS, fatty acid syn-
thase; ACC, acetyl-CoA carboxylase; G6P, glucose 6-phosphate;
G6Pase, glucose-6-phosphatase; F6P, fructose-6-phosphate; FBPase,
fructose-1,6-bisphosphatase; PEPCK, phosphoenolpyruvate carboxyki-
nase; Txnip, thioredoxin-interacting protein; STZ, streptozotocin;
DHAP, dihydroxyacetone phosphate.
THE JOURNAL OF BIOLOGICAL CHEMISTRY Vol. 279, No. 23, Issue of June 4, pp. 24387–24393, 2004
© 2004 by The American Society for Biochemistry and Molecular Biology, Inc. Printed in U.S.A.
This paper is available on line at http://www.jbc.org 24387
by guest on May 12, 2018http://www.jbc.org/Downloaded from
first described as a model of human familial combined hyper-
lipidemia (12). The gene responsible for the HcB-19 phenotype
is thioredoxin-interacting protein (Txnip) (13). A nonsense mu-
tation renders the mice Txnip-null, which may enhance the
activity of thioredoxin. Thioredoxin plays a role in buffering the
redox state of proteins in which the standard redox potential
(E°) of their disulfide bonds is within the physiological range
(14 –16). The HcB-19 mice, therefore, provide a new window
into processes that are regulated by a redox rheostat.
EXPERIMENTAL PROCEDURES
Animals and Streptozotocin Treatment—HcB-19 and C3H/DiSnA
mice derived from the colony at the University of California, Los Ange-
les (12, 13, 17, 18) were maintained under standardized conditions and
fed with rodent chow 5015 and water ad libitum. The light-cycle hours
were between 6 a.m. and 6 p.m. Streptozotocin (STZ) was injected
intraperitoneally (50 mg/kg in 0.1 Msodium citrate buffer, pH 4.50)
daily for 5 consecutive days. Control animals received the same volume
of citrate buffer. Plasma glucose and triglyceride were assessed 21 days
after the initial treatment.
Plasma Metabolites and Insulin Assays—Blood samples were col-
lected from mice under isofluorane anesthesia in heparinized capillary
tubes. Plasma was obtained by centrifugation at 12,000 ⫻gfor 5 min at
4°C. Glucose and triglycerides in plasma were assayed with commer-
cial kits from Sigma. Insulin and C-peptide were assayed using the
ultra sensitive rat/mouse insulin RIA kit (Linco) and C-peptide RIA kit
(Linco), respectively.
Glucose and Galactose Tolerance Tests—Glucose or galactose (3 g/kg
of body weight in 0.9% saline) was injected (intraperitoneal) into fasting
C3H and HcB-19 mice. Blood samples were collected by retro-orbital
bleeding at 0, 15, 30, and 60 min after injection and centrifuged at
12,000 ⫻gfor 5 min at 4 °C. Glucose levels in the plasma were assayed
with a commercial glucose diagnostic kit from Sigma.
Glucose 6-Phosphate (G6P) Phosphohydrolase Assays—Microsomes
from overnight-fasted mice were thawed on ice and diluted with ice-cold
0.25 Msucrose solution to 30 ml/g of wet liver weight. The microsomal
membrane was disrupted by the addition of 0.2% (w/v) sodium deoxy-
cholate. Enzyme assays were carried out in 0.1 Msodium cacodylate
buffer, pH 6.5, containing 20 mMG6P containing 100
g of microsome
protein per 0.75-ml reaction mixture. Incubations were at 30 °C for 10
min. The reactions were stopped by the addition of 0.5 ml of ice-cold
trichloroacetic acid. Denatured protein was sedimented by centrifuga-
tion. Aliquots of the 200-
l supernatant fraction were assayed for
inorganic phosphate by a colorimetric kit from Sigma.
Measurement of Gluconeogenic Intermediates in the Liver—Animals
FIG.1.Plasma triglyceride (TG), glucose, and ketone body levels in HcB-19 and control C3H mice. C3H (control) and HcB-19 were fed
a chow diet and water ad libitum in a room with a 12 h light cycle (lights on from 0600 to 1800). Blood was obtained from fed (open bars) or fasted
(filled bars) mice at 1000 h. Plasma levels of triglyceride (panel A), glucose (panel B), and ketone bodies (panel C) were measured as described under
“Experimental Procedures.”Results are presented as the mean ⫾S.D. from 12 mice in each group. The asterisk denotes statistical difference, p⬍
0.01.
FIG.2.Comparison of G6Pase activ-
ities and abilities to utilize galactose
in HcB-19 and control C3H mice.
Panel A, liver microsomes were prepared
from overnight fasted C3H and HcB-19
mice. G6Pase activity was measured by
following the amount of phosphate re-
leased over time and normalized to the
amount of microsomal protein in each as-
say. Results are presented as mean ⫾
S.D. from four mice in each group. The
asterisk denotes statistical difference, p⬍
0.05. Panel B, galactose (3 g/kg of body
weight in 0.9% saline) was injected (intra-
peritoneal) into fasting C3H (filled dia-
monds) and HcB-19 mice (open squares).
Blood samples were collected by retro-or-
bital bleeding at 0, 15, 30, and 60 min
after injection, and the amount of glucose
was determined. Results are presented as
the mean ⫾S.D. from five mice in each
group.
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were starved for 18 h before sacrifice. The livers were immediately
removed and frozen in liquid nitrogen. The frozen tissue was ground in
a porcelain mortar pre-cooled with liquid nitrogen. About1goftissue
powder was mixed with 5 ml of 0.6 Mperchloric acid and centrifuged.
The deproteinized supernatant fraction was removed and adjusted to
pH 3.50 with 5 Mpotassium carbonate. Metabolites were estimated by
standard spectrophotometric enzymatic assays as previously described
(19, 20). G6P and fructose 6-phosphate (F6P) assays were carried out in
0.2 Mtriethanolamine buffer containing 0.2 mMNADP-Na
2
and5mM
MgCl
2
. Glucose-6-phospate dehydrogenase was then added, and the
production of NADPH was monitored by following the absorbance at
339 nm. The amount of G6P in the samples was calculated from the
amount of NADPH generated. After all G6P in the sample has been
consumed, phosphoglucose mutase was added to convert F6P to G6P.
The amount of F6P in the samples was estimated by the additional
production of NADPH. Dihydroxyacetone phosphate (DHAP), glyceral-
dehyde 3-phosphate, and fructose-1,6-bisphosphate were assayed were
sequentially in 0.2 Mtriethanolamine buffer containing 20 mMEDTA
and 17
MNADH. Glycerol-3-phosphate dehydrogenase was then
added, and the conversion of NADH to NAD was followed by the change
in absorbance at 339 nm. The amount of DHAP in the samples was
calculated from the amount of NADH consumed. After the reaction has
been completed, triose-phosphate isomerase was added to convert glyc-
eraldehyde 3-phosphate into DHAP. The amount of glyceraldehyde
3-phosphate in the samples was estimated by the additional consump-
tion of NADH. Finally, for the estimation of fructose-1,6-bisphosphate,
aldolase was added to convert fructose-1,6-bisphosphate to DHAP and
the change in NADH was measured.
Measurement of Glutathione Levels in the Liver—Glutathione levels
in the liver were determined spectrophotometrically as described by
Anderson (21). Briefly, mice were sacrificed and perfused with ice-cold
PBS. Livers were excised and deproteinized with 10 volumes of 5%
5-sulfosalicylic acid. Total glutathione was determined using the 5,5⬘-
dithiobis(2-nitrobenzoic acid)-GSSG reductase recycling assay. The pro-
duction of 5-thio-2-nitrobenzoate was followed at 412 nm and is propor-
tional to the amount of total glutathione in the sample. Oxidized
glutathione was determined by the same assay after blocking the thiol
group of GSH with 2-vinylpyridine.
Quantitative Real-time PCR—Total RNA was isolated from the livers
of mice by using the RNeasy mini kit (Qiagen). cDNA was synthesized
using the Superscript First Strand Synthesis kit (Invitrogen) from 2
g
of total RNA (DNase I-treated) and random hexamer. Real-time PCR
was performed in 96-well plates using the Bio-Rad iCycler machine.
Typically, the 25-
l reaction contained 12.5
l of 2xSYBR PCR Green
Master Mix (Bio-Rad), 1
l of cDNA, and 125 nMforward and reverse
primers. All reactions were done in triplicate and optimized by melt
curve analysis to ensure nonspecific products and primer dimers were
not formed. The primer sequences used for SREBP-1a, SREBP-1c,
SREBP-2, FAS, ACC, PEPCK, and apoB have been described (1, 22).
ApoB mRNA was used as the invariant control. The relative amount of
mRNA in each sample was determined by the comparative C
T
method.
Statistical Analysis—Results are given as the mean ⫾S.D. Statisti-
cal significance was determined by two-tailed ttest. Values of p⬍0.05
were considered to be significant.
RESULTS
Loss of Txnip Is Associated with Fasting-induced Hypertri-
glyceridemia, Hypoglycemia, and Ketosis—As expected, over-
night fasting caused triglycerides to decrease 3-fold in control
mice (Fig. 1A). In striking contrast, plasma triglycerides in-
creased 4-fold in HcB-19 mice in response to fasting (Fig. 1A).
The fasting-induced hypertriglyceridemia uniquely displayed
by HcB-19 mice is consistent with previous findings showing
that the livers of HcB-19 mice secrete more VLDL particles (12,
13). However, the finding that HcB-19 mice showed no hyper-
lipidemia in the non-fasted state (Fig. 1A) suggests their met-
abolic disorder is distinct from familial combined hyperlipi-
demia proposed by earlier reports (12, 13).
Hepatic VLDL production rapidly adapts to nutritional sta-
tus (23). Long term fasting is associated with decreased VLDL
assembly and secretion (24, 25). The anomalous response to
fasting by HcB-19 mice suggests that Txnip plays a role in
eliciting the appropriate metabolic response to fasting.
Normal mice are able to maintain normal plasma glucose
levels during fasting in part by stimulating hepatic gluconeo-
genesis. In contrast to the plasma glucose levels in excess of
100 mg/dl in control mice, HcB-19 mice became hypoglycemic
(66.7 mg/dl) after a 14-h fast (Fig. 1B). Consistent with a
previous report (12, 13), HcB-19 mice also showed a striking
6.6-fold increase in ketone bodies when fasted and a ⬃2-fold
increase when fed (Fig. 1C).
Fasting-induced Hypertriglyceridemia and Hypoglycemia
Associated with Loss of Txnip Are Not Caused by Defective
Transport or Metabolism of Glucose 6-Phosphate—The fasting-
induced hypoglycemia and hypertriglyceridemia phenotype of
HcB-19 mice is similar to that of glycogen storage diseases
caused by a deficiency in hepatic G6Pase and/or the glucose
6-phosphate transporter in the endoplasmic reticulum (26, 27).
Our findings showing that hepatic microsomes from fasted
HcB-19 mice contain higher levels of G6Pase activity than
FIG.3.Glucose tolerance test. Glucose (3 g/kg of body weight in
0.9% saline) was injected (intraperitoneal) into fasting C3H (filled di-
amonds) and HcB-19 mice (open squares). Blood samples were collected
by retro-orbital bleeding at 0, 15, 30, and 60 min after injection, and the
amount of glucose was determined. Results are presented as the
mean ⫾S.D. from five mice in each group.
FIG.4.Steady-state levels of glycolytic/gluconeogenic intermediates in the livers of fasted HcB-19 and control C3H mice. Hepatic
contents of glycolytic/gluconeogenic intermediates in overnight-fasted control C3H (open bars) and HcB-19 (filled bars) mice were measured. Panel
A, steady-state levels of DHAP, glyceraldehyde 3-phosphate (GAP), and fructose-1,6-bis-phosphate (F-1,6-P2). Results are presented as the mean ⫾
S.D. from five mice in each group. Panel B, steady-state levels of G6P and F6P were assayed. Results are presented as the mean ⫾S.D. from five
mice in each group. The asterisk denotes statistical difference, p⬍0.01.
Txnip Loss Disrupts Appropriate Metabolic Response to Fasting 24389
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those from control mice (Fig. 2A) suggest that impaired G6Pase
activity is not responsible for the fasting-induced hypertriglyc-
eridemia, hypoglycemia, or ketosis associated with loss of
Txnip.
We also determined how loss of Txnip affects the ability of
liver in vivo to transport G6P into the lumen of the endoplasmic
reticulum and export it as glucose. Galactose is selectively
taken up by the liver for conversion to G6P, which can subse-
quently be used for the production of glucose for secretion into
the bloodstream. This process requires an intact function of the
G6Pase complex. Thus, the increase in plasma glucose after a
bolus of galactose provides an estimation of the relative flux of
substrate through G6Pase (28). As shown in Fig. 2B, injection
of a bolus of galactose (3 g/kg of body weight, intraperitoneal)
resulted in a similar increment in plasma glucose in both
groups of mice. These findings indicate that the fasting-in-
duced hypertriglyceridemia, hypoglycemia, and ketosis associ-
ated with loss of Txnip are not caused by defective transport or
metabolism of G6P.
Fasting-induced Hypertriglyceridemia and Hypoglycemia
Associated with Loss of Txnip Are Not Caused by Altered Rates
of Removal of Glucose from Plasma—To examine the ability of
each group of mice to remove glucose from plasma, fasted mice
were challenged with a bolus of glucose (3 g/kg of body weight,
intraperitoneal) (Fig. 3). Before glucose administration,
HcB-19 mice exhibited lower plasma glucose levels that were
⬃50 mg/dl less than those of control mice (Fig. 3). Both groups
exhibited similar net increments of plasma glucose as well as
similar rates of removal of glucose from plasma after the bolus
injection of glucose (Fig. 3). Thus, it appears that the fasting-
induced hypoglycemia associated with loss of Txnip is not
caused by accelerated removal of glucose from plasma and may
be the result of decreased hepatic gluconeogenesis and glucose
export.
Livers of Fasted HcB-19 Mice Display a Block Near the End
Point of Hepatic Gluconeogenesis—To determine whether stim-
ulation of hepatic gluconeogenesis is impaired in fasting
HcB-19 mice, steady-state levels of glycolytic/gluconeogenic in-
termediates in the livers of fasted mice were measured (Fig. 4).
Although the hepatic levels of fructose-1,6-bisphosphate (F-1,6-
P
2
) and triose phosphate intermediates (dihydroxyacetone
phosphate and glyceraldehyde 3-phosphate) were similar in
both groups, levels of G6P and F6P were markedly decreased in
HcB-19 mice (⬎70%, p⬍0.01) (Fig. 4). Together with the
finding that HcB-19 mice can utilize G6P from galactose for
glucose production (Fig. 2B), these data suggest that hypogly-
cemia is due to a lack of supply of G6P and F6P in the terminal
steps of gluconeogenesis.
The reduction in G6P and F6P in the fasting HcB-19 livers
could be due to decreased FBPase activity. The mRNA and
protein levels of FBPase were similar in C3H and HcB-19 mice
FIG.5.Sulfhydryl redox status in the livers of fasting HcB-19
and control C3H mice. Levels of total GSH and GSSG were measured
from perfused livers of overnight-fasted C3H (open bars) and HcB-19
(filled bars) mice. Results are presented as mean ⫾S.D. from five mice
in each group. The asterisk denotes statistical difference, p⬍0.05.
FIG.6.Plasma levels of insulin and C-peptide. Panel A, plasma insulin levels. C3H (control) and HcB-19 were fed a chow diet and water ad
libitum in a room with a 12-h light cycle (lights on from 0600 to 1800). Blood was obtained from fed (open bars) or fasted (filled bars) mice at 1000 h.
Plasma levels of insulin were measured by RIA. Panel B, plasma C-peptide levels in fasting mice. Blood was obtained from fasting C3H (open bars)
and HcB-19 (filled bars) mice at 1000 h. Plasma levels of C-peptide were measured by radioimmunoassay. Results are presented as the mean ⫾
S.D. from six mice in each group. The asterisk denotes statistical difference, p⬍0.01.
FIG.7.Effects of streptozotocin treatment on the hypertriglyceridemia and hypoglycemia phenotypes exhibited by fasted HcB-19
mice. STZ was injected intraperitoneally (50 mg/kg in 0.1 Msodium citrate buffer, pH 4.50) daily for 5 days into C3H (open bars) and HcB-19 mice
(filled bars). Control animals in each strain of mice received the same volume of citrate buffer. After 21 days, blood samples were collected from
overnight-fasted mice in each group. Plasma levels of triglycerides (panel A) and glucose (panel B) were determined. Results are presented as the
mean ⫾S.D. from five mice in each group. The asterisk denotes statistical difference, p⬍0.01.
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(Northern and Western blotting, data not shown), suggesting
that the change in FBPase activity is due to post-translational
modification and/or allosteric control.
Loss of Txnip Is Associated with Increased Thiol Redox
(GSH/GSSG) Status, an Allosteric Regulator of Gluconeogene-
sis/Glycolysis—FBPase enzyme activity is negatively regulated
by fructose 2,6-bisphosphate (5). This inhibition is exquisitely
dependent upon the thiol (cysteine) redox state of the enzyme,
the reduced form being more susceptible to the inhibition by
fructose2,6-bisphosphate (29). Thus, gluconeogenesis and gly-
colysis are reciprocally responsive to the ratio of reduced glu-
tathione:oxidized glutathione (GSH/GSSG) (30). A ⬃50% in-
crease in the ratio of GSH/GSSG in renal tubules is associated
with an up to 20-fold increased rate of gluconeogenesis (30).
We, therefore, measured the GSH/GSSG ratio in the livers of
both groups of fasted mice. In HcB-19 mice, the hepatic GSH/
GSSG ratio was increased by 30% (p⬍0.05) (Fig. 5). The 30%
increased GSH/GSSG ratio in the liver displayed by HcB-19
mice is sufficient to account for the apparent block in FBPase
observed in the livers of fasted HcB-19 mice (Fig. 4).
Loss of Txnip Is Associated with Increased Plasma Levels of
Insulin and C-peptide—Because insulin suppresses gluconeo-
genesis and negatively regulates FBPase activity, we measured
the plasma insulin levels in HcB-19 mice. As shown in Fig. 6A,
plasma insulin concentrations were significantly elevated in
both fed and fasting HcB-19 mice. In the fed state, plasma
insulin levels in HcB-19 mice were about 50% higher than that
of control. After an 18-h fast, the difference in plasma insulin
levels between the 2 groups of mice was ⬃3-fold (Fig. 6A).
Plasma C-peptide levels in fasted HcB-19 mice also showed a
similar ⬃3-fold increase (Fig. 6B). These findings suggest that
elevated plasma insulin levels in HcB-19 mice are linked to
enhanced pancreatic

-cell secretion rather than reduced he-
patic insulin clearance.
Livers from Fasted HcB-19 Mice Display a Selective Resist-
ance to Hyperinsulinemia—Surprisingly, the hyperinsulinemia
displayed by fasted HcB-19 mice was not associated with a
detectable increase in the hepatic content of fructose 2,6-
bisphosphate or reduced activity of fructose-1,6-bisphos-
phatase (data not shown).
Normally, insulin suppresses the expression of PEPCK.
However, despite the 3-fold increase in insulin in fasted
HcB-19 mice relative to normal mice, PEPCK expression in
fasted HcB-19 mice was unchanged (i.e. not suppressed) com-
pared with fasted controls (Table I). Interestingly, fed mice
from both groups exhibited decreased expression of PEPCK
mRNA and increased expression of lipogenic SREBP-1c,
SREBP-2, ACC, and FAS compared with the levels displayed
when fasted (Table I).
A second physiological function of PEPCK is glyceroneogen-
esis (2). The hyperlipidemic phenotype of the fasted HcB-19
mice would be consistent with an abnormally increased diver-
sion of PEP toward glycerol production (via glycerol-3-phos-
phate dehydrogenase) and lipogenesis (31, 32). Consistent with
increased lipogenesis, SREBP-1c levels in the fasted HcB-19
mice were 3.3-fold higher than those of control mice (Table I).
As expected, the expression of SREBP-1c target genes, acetyl-
CoA carboxylase, and fatty acid synthase were also increased
2-fold in fasted HcB-19 mice (Table I).
Because the changes in lipogenesis correlate with hyperin-
sulinemia, we ablated the insulin-producing

-cells of the normal
and HcB-19 mice with STZ. In addition to the expected hyper-
glycemia associated with loss of insulin signaling, STZ treatment
completely blocked the fasting-induced hypertriglyceridemia in
the HcB-19 mice (Fig. 7). Thus, the fasting-induced hypertriglyc-
eridemia of the HcB-19 mice is dependent upon insulin.
DISCUSSION
Animals are able to reprogram their metabolic pathways to
adapt to changes in nutrient availability, hormonal status, and
energy demands. The mechanisms require sensing these stim-
uli and bringing about a change in the abundance or activation
state of metabolic enzymes and regulators of gene expression. A
recurring theme in metabolism is that cells sense their “energy
charge”by responding to changes in ATP or AMP or to changes
in “redox potential”as reflected in NAD(P)H/NAD⫹(P) and
GSH/GSSG. The cysteine residues of many proteins exist in a
dynamic state between the reduced free sulfhydryl and the
oxidized disulfide bridge. There are many in vivo processes that
allow redox potential to equilibrate NAD(P)H/NAD
⫹
(P), GSH/
GSSG, and protein sulfhydryl reduction/oxidation. The ubiqui-
tous enzyme thioredoxin is mainly responsible for equilibrating
NAD(P)H/NAD
⫹
(P) redox potential with protein sulfhydryl re-
dox state via the oxidation of NADPH (33–35). Thioredoxin
function can itself be modulated by its interaction with its
inhibitory protein partner, Txnip (36, 37). The availability of a
FIG.8.Regulation of glycolysis, gluconeogenesis, and triglyc-
eride biosynthesis by insulin, SREBP-1c, and cellular sulfhydryl
redox. Activities of key enzymes in glycolysis, gluconeogenesis, and
triglyceride (TG) synthesis are modulated by insulin (blue arrows),
SREBP-1c (red arrows), and thiol redox status (yellow arrows). In the
context of fasting HcB-19 mice with elevated plasma insulin, increased
hepatic SREBP-1c mRNA expression combined with a greater reduced
thiol redox status act in concert to activate enzymes in glycolysis and
triglyceride biosynthesis and to reciprocally suppress gluconeogenic
enzymes. Note that SREBP-1c is required to induce glucose-6-phos-
phate dehydrogenase in response to refeeding but is not required for
expression in fasted mice (see Ref. 57). TCA, tricarboxylic acid; HK,
hexokinase; GK, glucokinase; PFK, phosphofructokinase; Gly3PDH,
glycerol-3-phosphate (Gly-3-P) dehydrogenase; PDH, pyruvate dehy-
drogenase; ME, malic enzyme; ATPCL, ATP:citrate lyase; GPAT, glyc-
erol-3-phosphate acyltransferase; OAA, oxaloacetate; 1,3-BPG, 1,3-
bisphosphoglycerate; PC, pyruvate carboxylase; GAP, glyceraldehyde
3-phosphate.
Txnip Loss Disrupts Appropriate Metabolic Response to Fasting 24391
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Txnip-null mutant mouse (13) provided an opportunity to dis-
cover the metabolic pathways that are affected by the loss of
Txnip. This study establishes a causal connection between loss
of Txnip resulting in enhanced sulfhydryl reduction and dys-
regulated carbohydrate and lipid metabolism. The work sug-
gests that Txnip plays a role in at least two tissue sites, the
liver and pancreatic

-cells.
To maintain homeostasis the liver must balance the flux of
carbon units into gluconeogenesis with metabolic needs by
sensing blood glucose and integrating this information with
energy stores and redox state. Glucose sensing occurs both
directly and through insulin. The discovery that SREBP-1c is
an insulin target explained how hepatocytes modify the expres-
sion of enzymes in glycolysis and lipogenesis appropriate to the
level of blood glucose (1, 38, 39).
In addition to blood glucose, cells respond to their own inter-
nal energy status. Fasting is associated with a more oxidized
sulfhydryl redox state (40). Our results establish a connection
between redox status, Txnip, and metabolic adaptation to fast-
ing. Instead of becoming more glucogenic, the fasting liver of a
Txnip-null mouse is lipogenic. The dearth of glucose leads to
hypoglycemia and ketosis.
The fasted HcB-19 mice are hyperinsulinemic. Yet, they fail
to suppress the expression of PEPCK. Together with the induc-
tion of SREBP-1c and its regulated genes, this presents a
picture of selective insulin resistance analogous to those previ-
ously reported by Shimomura and co-workers (41) in lipodys-
trophic mice. PEPCK catalyzes the formation of PEP, a precur-
sor for both glucose and glycerol production. In fasted HcB-19
mice, PEP is selectively channeled into glyceroneogenesis due
to the block in FBPase (Fig. 4) and the increased demand for
triglyceride synthesis caused by increased plasma levels of
fatty acids observed in HcB-19 mice (12, 13) returning to the
liver and increased hepatic synthesis due to increased expres-
sion of ACC and FAS (Table I).
Sulfhydryl redox state, as reflected by the ratio of cellular
GSH/GSSG, reciprocally regulates enzymes involved in glu-
coneogenesis and glycolysis (for review, see Ref. 42) such as
hepatic FBPase (gluconeogenesis) (43) and phosphofructoki-
nase (glycolysis) (44). In addition, sulfhydryl redox state also
modulates the activity of enzymes involved in fatty acid and
glycerolipid biosynthesis such as ATP-citrate lyase (45, 46),
FAS (47), glycerol-3-phosphate dehydrogenase (48), and glyc-
erol-3-phosphate acyltransferase (49) (summarized in Fig. 8).
The findings showing that GSH in the livers of fasted HcB-19
mice is 30% more reduced (Fig. 5) may explain the decreased
flux of carbon units through FBPase and increased production
of fatty acids and glycerolipids. As a result, carbon units are
secreted as triglycerides as a component of VLDL (12, 13). The
data showing increased hepatic content of mRNAs encoding the
lipogenic transcription factor SREBP-1c and two of its tran-
scriptional targets (ACC and FAS) (Table I) in fasted HcB-19
mice provides an additional mechanism through which insulin
enhances the flow of carbon units from glucose export into
hepatic VLDL secretion.
Our findings suggest a role for Txnip in the pancreatic

-cells. The increased insulin secretion in fasted HcB-19 mice
could be due to increased secretion by individual

-cells or
increased

-cells mass. We suspect the latter is more likely.
Txnip has been shown to block the thioredoxin-sulfhydryl
reduction by NADPH (36). This finding predicts that the
absence of Txnip in HcB-19 mice would lead to increased
thioredoxin reduction activity (50). Pancreatic

-cells contain
abundant levels of thioredoxin (51), which may contribute to
the intracellular processing and secretion of insulin (52). It is
believed that thioredoxin facilitates the processing and mat-
uration of insulin (36) and, thus, may prevent unfolded pro-
tein response-induced apoptosis of pancreatic

-cells (53, 54).
Transgenic overexpression of thioredoxin in pancreatic

-cells protects mice from STZ-induced and autoimmune di-
abetes (51). Txnip-thioredoxin interactions may be an effec-
tive target for promoting insulin secretion without causing
pancreatic

-cell apoptosis.
Glucose causes a large increase in Txnip expression in pan-
creatic

-cells (55) and in cultured fibroblasts (56). This re-
sponse links nutritional state (e.g. glucose uptake) with redox
state and subsequent metabolic regulation. Our findings fur-
ther suggest that the cellular redox state provides a unifying
parameter linking cellular response to nutritional state. This
response is tuned via Txnip-mediated changes in sulfhydryl
redox potential.
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Txnip Loss Disrupts Appropriate Metabolic Response to Fasting 24393
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Alan D. Attie and Roger A. Davis
To Yuen Hui, Sonal S. Sheth, J. Matthew Diffley, Douglas W. Potter, Aldons J. Lusis,
Redox State to Appropriate Response to Nutritional Signals
Mice Lacking Thioredoxin-interacting Protein Provide Evidence Linking Cellular
doi: 10.1074/jbc.M401280200 originally published online March 26, 2004
2004, 279:24387-24393.J. Biol. Chem.
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