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* Department of Clinical Biochemistry, University of Cambridge, Addenbrookes Hospital, Cambridge, UK;
Ingenium Pharmaceuticals AG, Martinsried, Germany;
Diabetes Research Unit, Boston Medical Center, Boston, Massachusetts, USA;
Metabolic Research Laboratory, Oxford Centre for Diabetes, Endocrinology and Metabolism, Nuffield Department of Clinical Medicine, University of Oxford, Churchill Hospital, Oxford, UK;
|| Department of Biochemistry, University of Cambridge, Cambridge, UK; and

Cellular Regulation, MRC Dunn Human Nutrition Unit, Cambridge, UK
2 Correspondence: Department of Clinical Biochemistry, University of Cambridge, Addenbrookes Hospital, Hills Road, Box 232, Cambridge CB2 2QR, UK. E-mail: ajv22{at}cam.ac.uk
Nonalcoholic steatohepatitis (NASH) is a common feature of the metabolic syndrome and toxic reactions to pharmacological drugs. Tamoxifen, (TMX) a widely used anti-breast cancer drug, can induce NASH and changes in plasma cholesterol levels through mechanisms that are unclear. We studied primary actions of TMX using a short-term treatment (5 days) that induces microvesicular hepatic steatosis and marked hypercholesterolemia in male rats. Using a combined approach of gene expression profiling and NMR-based metabolite analysis, we found that TMX-treated livers have increased saturated fatty acid content despite changes in gene expression, indicating decreased de novo lipogenesis and increased fatty acid oxidation. Our results show that TMX predominantly down-regulates FAS expression and activity as indicated by the accumulation of malonyl-CoA, a known inhibitor of mitochondrial ß-oxidation. In the face of a continued supply of exogenous free fatty acids, the blockade of fatty acid oxidation produced by elevated malonyl-CoA is likely to be the major factor leading to steatosis. Use of a combination of metabolomic and transcriptomic analysis has allowed us to identify mechanisms underlying important metabolic side effects of a widely prescribed drug. Given the broader importance of hepatic steatosis, the novel molecular mechanism revealed in this study should be examined in other forms of steatosis and nonalcoholic steatohepatitis.Lelliott, C. J., López, M., Curtis, R. K., Parker, N., Laudes, M., Yeo, G., Jimenez-Liñan, M., Grosse, J., Saha, A. K., Wiggins, D., Hauton, D., Brand, M. D., ORahilly, S., Griffin, J. L., Gibbons, G. F., Vidal-Puig, A. Transcript and metabolite analysis of the effects of tamoxifen in rat liver reveals inhibition of fatty acid synthesis in the presence of hepatic steatosis.
Key Words: fatty acid synthase malonyl-CoA metabolomics metabolic pathways
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