Abstract Background: Bile salt export pump (BSEP/ABCB11) is important in the maintenance of the enterohepatic circulation of bile acids and drugs. Drugs such as rifampicin and glibenclamide inhibit BSEP. Progressive familial intrahepatic cholestasis type-2, a lethal pediatric disease, some forms of intrahepatic cholestasis of pregnancy, and drug-induced cholestasis are associated with BSEP dysfunction. Methods: We started with a bioinformatic approach to identify the relationship between ABCB11 and other proteins, microRNAs, and drugs. A microarray data set of the liver samples from ABCB11 knockout mice was analyzed using GEO2R. Differentially expressed gene pathway enrichment analysis was conducted using ClueGo. A protein-protein interaction network was constructed using STRING application in Cytoscape. Networks were analyzed using Cytoscape. CyTargetLinker was used to screen the transcription factors, microRNAs and drugs. Predicted drugs were validated on human liver cell line, HepG2. BSEP expression was quantified by real-time PCR and western blotting. Results: ABCB11 knockout in mice was associated with a predominant upregulation and downregulation of genes associated with cellular component movement and sterol metabolism, respectively. We further identified the hub genes in the network. Genes related to immune activity, cell signaling, and fatty acid metabolism were dysregulated. We further identified drugs (glibenclamide and ATP) and a total of 14 microRNAs targeting the gene. Western blot and real-time PCR analysis confirmed the upregulation of BSEP on the treatment of HepG2 cells with glibenclamide, ATP, and metformin. Conclusions: The differential expression of cell signaling genes and those related to immune activity in ABCB11 KO animals may be secondary to cell injury. We have found glibenclamide, ATP, and metformin upregulates BSEP. The mechanisms involved and the clinical relevance of these findings need to be investigated. Keywords: BSEP/ABCB11, ABCB11-KO, Insilico, upregulation, HepG2, glibenclamide, ATP, and metformin, Nuclear Receptors Introduction The bile salt export pump (BSEP), the major bile salt transporter in the liver canalicular membrane, is coded by ABCB11 gene, and mutations in this gene cause progressive familial intrahepatic cholestasis type- 2 (PFIC-2) ^[31]1, [32]2. Besides PFIC-2, mutations or insufficiency of BSEP is associated with a variety of diseases such as drug-induced cholestasis, pregnancy induced cholestasis, cryptogenic cholestasis, cholangiocarcinoma and hepatocellular carcinoma, which are cancers of the liver ^[33]3– [34]7. Naturally, ABCB11 expression is induced by bile salts and is mediated by FXR- RXR heterodimer ^[35]8. Here in this pilot study we explored in silico the interactions/networks around ABCB11. We wanted to identify the genes, drugs, microRNAs which might influence the expression of ABCB11. Drugs which could upregulate ABCB11 expression may be useful in ABCB11 haploinsufficiency and inhibition of the pump could result in the accumulation of toxic bile salts inside hepatocytes. Modulation of ABCB11 expression could be clinically beneficial in a variety of medical conditions. Methods Identification of differentially expressed genes We analyzed the microarray data set of the liver samples from ABCB11 knockout mice (GEO accession [36]GSE70179) using GEO2R online tool from NCBI ^[37]9. All differentially expressed genes (DEGs) were filtered with two criteria: -1> log [2]FC >+1 and adj. p-value <0.05. Pathway enrichment analysis To identify DEGs which are significant, pathway enrichment analysis was conducted using the [38]ClueGo v2.5.5 app from Cytoscape ^[39]10. ClueGo constructed and compared networks of functionally related GO terms with kappa statistics, which was adjusted at >0.4 in this study. Identification of hub genes and subnetwork analysis The protein-protein interaction (PPI) networks were built by the [40]Search Tool for the Retrieval of Interacting Genes (STRING v11.0) ^[41]11 and [42]Cytoscape v3.7.1 software. The [43]Molecular Complex Detection (MCODE v1.6), app from Cytoscape was used to screen modules of the PPI network with degree cut-off = 2, node score cut-off = 0.2, k-core = 2, and maximum depth = 100. The hub genes were identified by the [44]CytoHubba v0.1 app. The top 10 nodes were considered as notable hub genes and displayed. Identification of transcription factor and drug target [45]CyTargetLinker v4.1.0 from Cytoscape was used to identify the transcription factors (TFs) and microRNAs using ENCODE and Target-scan databases, respectively. We drew Homo sapiens TF-target interactions linkset from database (ENCODE) ^[46]12 and drug-target interactions linkset from the database (DrugBank) ^[47]13. The networks were visualized and analyzed using Cytoscape v3.7.1 Cytoscape app [48]CyTargetlinker version 4.1.0[6] was used to screen the transcription factors and microRNAs Cell culture HepG2 cells were grown in high-glucose DMEM (Hi-Media Lab, Mumbai, Cat. # AL111-500ML) supplemented with 10% fetal bovine serum (CellClone, Genetix Biotech Asia, New Delhi, Cat.# CCS-500-SA-U), penicillin and streptomycin (Hi-Media, Mumbai Cat. # A018-5X100ML). When cells became 80% confluent, they were individually treated with glibenclamide (500 ng/mL) ^[49]14, metformin (25 mg/L) ^[50]15 or ATP (1 mM) for 48 h. After 48 h cells were scraped out for total protein and RNA. Western blot analysis Total proteins from HepG2 cells were prepared and run on 10% SDS-PAGE and transferred to a PVDF membrane using a transfer apparatus following the standard protocols (Bio-Rad). After incubation with 5% nonfat milk in TBST (10 mM Tris, pH 8.0, 150 mM NaCl, 0.5% Tween 20) for 1 h the membrane was washed once with TBST and incubated overnight at 4°C with rabbit antibodies against human ABCB11 (Affinity, Catalog #DF 9278) 1: 2000 dilution; mouse anti-human β-actin (Santa Cruz Cat.# SC4778), dilution 1:1000. The membrane was washed three times (TBST) and incubated with a 1:5000 dilution of horseradish peroxidase-conjugated anti-rabbit (Santa Cruz Cat# SC-2004)/anti-mouse antibodies (Cat.#SC-2005) for 2 h. Blots were washed with TBST four times and developed with the ECL system (Bio-Rad, US Cat.#170-5060) according to the manufacturer's protocol. The western blot images were acquired using iBright CL1000 (Invitrogen, Thermo Fisher Scientific). Real-time PCR Total RNA was isolated using NucleoZOL (Takara Cat. No. 740404.200) following manufacturer's instruction. cDNA was prepared from (deoxyribonuclease treated) total RNA using RevertAid Reverse Transcriptase (Thermo Cat. No. EP0441) following the manufacturer's instructions. Real Time PCR was done with unique oligonucleotide primers targeting ABCB11 and GAPDH, Ta=60°C, in triplicates and two repeats, using GoTaq® qPCR Master Mix (Promega Cat. No. A6001) following 'manufacturer's instructions on a Veriti Thermo Cycler from Applied Biosystems Waltham, Massachusetts, USA and data was acquired using the software associated with the same machine (ViiA7 V1.2) and relative quantification was calculated using the by 2 ^(–ΔΔCt) method. Oligonucleotide primer sequences are listed in [51]Table 3. An earlier version of this article can be found on biorxiv.org (DOI: [52]https://doi.org/10.1101/2020.09.01.277434). Results Expression of 560 genes changed significantly following ABCB11-KO in 1.5 m mice Gene expression profile ABCB11 knockdown dataset GSE 70179 from GEO datasets were analysed with GEO2R tool. Genes with >2-fold change in expression value and <0.05 adjusted p-value was filtered. Identified differentially expressed genes (DEG) from the GSE dataset were classified in two groups - upregulated (375 genes) and downregulated (185 genes) ( Extended data, Supp.Table-1) ^[53]36. Gene ontology analysis was performed for functional analysis of DEGs by using ClueGo app from Cytoscape. PPIs of DEGs were constructed using STRING database showed an upregulation of genes related to cellular transport (pink colored nodes), and these nodes were also shared by Toll-like receptor (TLR) signalling ( [54]Figure 1). Downregulated genes were involved in metabolic pathways (sterol, carbohydrate, alcohol, etc.) ( Extended data, Supp. Table-2) ^[55]36. We next identified top hub genes in PPI network using CytoHubba app from Cytoscape ( [56]Table 1). Immunologically important genes were among the top ranked upregulated hub genes ( [57]Figure 2a) downregulated group majorly represents cell signaling and fatty acid metabolism ( [58]Figure 2b). Epidermal growth factor receptor ( EGFR) ranked first among the genes involved in signaling pathways. Kinases play a role in the transcription, activity, or intracellular localization of ABC transporters as do protein interactions ^[59]16. Proteins interacting with ABCB11 are represented in [60]Figure 3 which includes nuclear receptors NR1H4 and NR0B2. Most proteins were associated with bile acid metabolism and transport. Figure 1. Protein-protein interaction networks (PPIs) of DEGs were constructed using STRING database. [61]Figure 1. [62]Open in a new tab Gene ontology analysis was performed for functional analysis of DEGs by using ClueGo app from Cytoscape. This app allows simultaneous analysis of multiple annotation and ontology sources. Functionally grouped network is represented Figure 1a (upregulated genes) 1b (downregulated genes) . The node size represents enrichment significance and connections are based on kappa score (> 0.4). In upregulated gene group maximum number of nodes which are in pink color represent the cellular component movement. These nodes are shared by toll like receptor signaling pathway. Table 1. Genes with the greatest changes in expression. We observed that the top ranked hub genes in PPI network which were upregulated were associated with immune activity while those downregulated are associated with cell signaling and fatty acid metabolism. EGFR came first in the ranking which is a critical receptor in several cell signaling pathways. (A) Upregulated genes Rank Gene UniportKB/Swiss-Prot Function 1 CXCL 10 Pro-inflammatory cytokine 2 IFIH1 Cytoplasmic sensor of viral nucleic acids 3 IFT1 IFN-induced antiviral protein 4 IFT2 IFN-induced antiviral protein 5 OASL Antiviral activity 6 RSAD2 Induces type 1 and type 2 interferon 7 GBP2 Hydrolyzes GTP TO GMP 8 SAMD9L Growth factor signaling 9 ISG20 Interferon -induced antiviral activity 10 CMPK2 Participate in DUTP and dCTP synthesis in mitochondria (B) Downregulated genes 1 EGFR Convert extracellular cues into appropriate cellular responses 2 PPARA Ligand -activated transcription factor 3 CXCL12 Chemoattractant active on T-lymphocytes and monocytes 4 ENPP1 Nucleotide pyrophosphatase that genetrates diphosphate(ppi) 5 DGAT2 Triacylglycerol synthesis 6 PPAP2B Lipid phosphatase activity 7 LPIN1 Fatty acid metabolism 8 MGLL Converts mono-acylglycerides to free fatty acids and glycerol 9 SYT1 Calcium sensor 10 MIA3 Vesicle mediated transport [63]Open in a new tab Figure 2. We identified top hub genes in PPI network of both upregulated and downregulated genes by using CytoHubba app from Cytoscape. [64]Figure 2. [65]Open in a new tab We observed that the top ranked hub genes in the upregulated group were mainly related to immune activity ( a). The top hub genes in downregulated group were associated with cell signaling and fatty acid metabolism. EGFR emerged as the top hub gene, a growth factor receptor which is crucial factor several cell signaling pathways ( b). Figure 3. A protein-protein interaction network of the ABCB11 gene was constructed using the STRING app in Cytoscape with confidence score > 0.4 for Homo sapiens. [66]Figure 3. [67]Open in a new tab This network was constructed to analyze the relationship between ABCB11 and other proteins. Cytohubba app was used to calculate centrality of each node by MCC method. Node colour (red to yellow) represents the significance of the centrality in the group. In this analysis, we counted 11 nodes and 42 edges. These proteins majorly involved in bile acid metabolism and transport. Most of these genes are participant of more than one pathway which was expected because these pathways intersect and coregulated. We also mapped the NR0B2 protein, which is participate in sterol metabolism. As described, sub-network analysis was performed using MCODE ( [68]Figure 4), and CMPK2, ACTG1, and SSTR2 emerged as seed nodes among upregulated genes ( [69]Table 2). Among downregulated gene groups, only one subnetwork was found to be significant which had three genes: MIA3 (which codes a protein which is important in the transport of cargos that are too large to fit into COPII-coated vesicles such as collagen VII), IGFBP4 (encoding a protein that binds to both insulin-like growth factors and modifies their functions) and NOTUM (encoding a carboxylesterase that acts as a key negative regulator of the Wnt signaling pathway by specifically mediating depalmitoleoylation of WNT proteins). Figure 4. Sub-network analysis was conducted by using the Molecular Complex Detection (MCODE) app from Cytoscape. [70]Figure 4. [71]Open in a new tab Top sub-networks on the basis of MCODE score (Degree cut-off= 2, node score cut-off = 0.2, k-core = 2 and max. depth = 100). Upregulated gene group clusters, we identified seed nodes (CMPK2, ACTG1 and SSTR2) in the network (green and blue). In downregulated gene group, we identified only one subnetwork which qualified cut off criteria. Three genes in this sub-network was identified: MIA3, IGFBP4 and NOTUM (red). Table 2. Sub-network analysis. Sub-network analysis was performed using the Molecular Complex Detection (MCODE) app from Cytoscape and CMPK2, ACTG1 and SSTR2 emerged as seed nodes among upregulated. Sub- network Seed gene UniportKB/Swiss-Prot Function Diseases involved 1 CMPK2 This gene encodes one of the enzymes in the nucleotide synthesis salvage pathway that may participate in terminal differentiation of monocytic cells May participate in dUTP and dCTP synthesis in mitochondria Retinitis Pigmentosa 39 and Thiamine- Responsive Megaloblastic Anemia Syndrome 2 ACTG1 Actins are highly conserved proteins that are involved in various types of cell motility Deafness, Autosomal Dominant 20 and Baraitser-Winter Syndrome 2 3 SSTR2 Receptor for somatostatin-14 and -28 Neuroendocrine Tumor and Growth Hormone Secreting Pituitary Adenoma Cirrhotic liver and HCC express SSTRs. [72]Open in a new tab Table 3. Oligonucleotide primers used for real time PCR. Gene Forward Reverse GAPDH GAAGGTGAAGGTCGGAGT GAAGATGGTGATGGGATTTC ABCB11 CCTCCATCCGGCAACGCT CACTGAATTTCAGAATCCTCCTAACTGGG [73]Open in a new tab Using CyTargetLinker identified two drugs, glibenclamide, and ATP, directly targeting ABCB11. We subsequently looked for microRNAs [Target-scan database] ^[74]17 that were associated with ABCB11, and a total of 14 microRNAs were identified targeting the gene ( [75]Figure 5). Transcription factors and microRNAs targeting ABCB11 and interacting partners are represented in [76]Figure 6. Figure 5. CyTargetlinker was used to screen microRNAs using the Target-scan database. [77]Figure 5. [78]Open in a new tab We identified microRNAs that were associated with ABCB11. In total 14 microRNA identified targeting the gene. Figure 6. Cytoscape app CyTargetlinker version 4.1.0 was used to screen the transcription factors and microRNAs using ENCODE and Target-scan databases, respectively. [79]Figure 6. [80]Open in a new tab In the screen of transcription factors of ABCB11 interaction network we observed 21 nodes and 52 edges. Among these transcription factors, FOXA have been suggested an important factor in bile duct development and lipid accumulation. HNF4A in the regulation dyslipidaemia and terminal liver failure and JUND in fibrosis development. Others can be investigated in future studies. We counted 55 nodes and 89 edges in the search of microRNA targeting the ABCB11 network. Four genes ( ABCB11, ATP8B1, SLC10A2 and NR1H4) targeted by multiple microRNAs also some microRNA such as has-miR-203a-3p.2 and has-miR-203a-3p.2 target more than one gene. By nature, a microRNA can regulate several pathways therefore it would be interesting to study in future the dysregulation of these microRNAs and interaction with Identified transcription factors. Glibenclamide ATP and Metformin upregulates ABCB11 We evaluated in vitro, the effect of three drugs, two of which were bioinformatically predicted (Glibenclamide, ATP) and one based on literature ^[81]18. We found all the three compounds upregulating ABCB11 expression based on qPCR, and this was confirmed by western blot ( [82]Figure 7). Unannotated western blot images and raw qPCR Ct values are available as Underlying data ^[83]36. Figure 7. Three drugs, two of which were bioinformatically predicted (Glibenclamide, ATP) and one (Metformin) based on evidence from literature. [84]Figure 7. [85]Open in a new tab All the three compounds upregulated ABCB11 expression based on Real Time PCR data. This was further confirmed by Western Blot against anti-human ABCB11 antibody as the primary antibody. The upper image in 7b shows the PVDF membrane probed with antibody against ABCB11 and the lower image shows the same membrane stripped and probed with antibody against beta-actin (loading control). Discussion We identified several immunologically important genes being upregulated during ABCB11 deficiency. The reason could be liver cell injury secondary to bile salt accumulation, which triggers the sterile immune response ^[86]19, [87]20 and the downregulation of transport proteins and metabolically important genes could be because of decreased liver function following damage. A regenerative response follows cell injury, and a host of genes involved in regeneration are upregulated ^[88]21– [89]23; however, it appears that bile salts in the absence of BSEP hamper the regenerative response reflected by dysregulated collagen transporting protein MIA3 and NOTUM a protein involved in Wnt signaling. It's also possible that EGFR is dysregulated via accumulating bile salts mediated by STAT3 ^[90]24. We have observed an upregulation of ABCB11 in a liver cell line (HepG2) on treatment with glibenclamide, metformin, and ATP. This expression is upregulation may be a compensatory mechanism in the case of glibenclamide and metformin because these drugs are known to inhibit ABCB11 ^[91]25. Metformin is known to interfere with ABCB11 function, mediated through AMPK-FXR crosstalk ^[92]18 involving metformin induced FXR phosphorylation. ATP acts through ATP receptors on hepatocytes ^[93]26, [94]27. ATP is known to cross the plasma membrane ^[95]28 and this can act via AMPK. However, ATP has a very short half-life ^[96]29, and it may be converted to ADP, which can activate AMPK ^[97]30. In a recent report, metformin was shown to suppress ABCB11 expression, which is not in agreement with our observation, however, they performed their experiment on primary human hepatocytes, and they have also treated their cells with dimethylsulfoxide (DMSO) ^[98]31. There are many reports stating the influence of DMSO on human gene expression. For example, Verheijen et al. “exposed 3D cardiac and hepatic microtissues to medium with or without 0.1% DMSO and analyzed the transcriptome, proteome and DNA methylation profiles”. They found that “in both tissue types, transcriptome analysis detected >2000 differentially expressed genes affecting similar biological processes, thereby indicating consistent cross-organ actions of DMSO”. In both tissue types, the transcriptome analysis detected over 2000 differentially expressed genes affecting similar biological processes ^[99]32. Moskot et al. reported alterations of lysosomal ultrastructure upon DMSO treatment ^[100]33. Alizadeh et al. reported that DMSO catalyzes hepatic differentiation of adipose tissue-derived mesenchymal stem cells ^[101]34. It has been observed that “culturing pluripotent stem cells in DMSO activates the retinoblastoma protein, increases the proportion of cells in the early G1 phase of the cell cycle, and subsequently improves their competency for directed differentiation into multiple lineages in more than 25 stem cell lines” ^[102]35. However, we are not sure whether the observed difference is attributed to DMSO. In conclusion, we need more experiments to determine the mechanisms of action of these drugs on the upregulation of ABCB11. Many changes in gene expression following ABCB11 knockout could be secondary to stress, immune and regenerative responses following hepatocyte injury in mice liver. Data availability Underlying data Harvard Dataverse: Real Time PCR for ABCB11 and few NRs. [103]https://doi.org/10.7910/DVN/AOYKY7 ^[104]36. This project contains the following underlying data: * 2020-09-12 092712-ViiA7-export.xls. (qPCR data following addition of ATP, metformin or gilbenclamide.) * ABCB11 WESTERN BLOT DRUG.tif. (Unannotated western blot image for ABC11.) * ABCB11_WB_Repeat_Drugs.tif. (Unannotated repeat western blot image for ABC11.) * actin drug.tif. (Unannotated western blot image for β-actin.) * Actin_2020_07_11_182456.jpg. (Unannotated western blot image, including β-actin loading control.) * Actin_2020_07_11_182456.tif. (As above, but in tif format.) * nisha_qPCR DATA_ 7142020.xls. (qPCR data for ABC11 and other indicated genes.) * realtime and western blottt (1).pptx. (Western blot and qPCR data pooled into a single file.) * Repeat_Actin_drug_WB.tif. (Unannotated repeat western blot image for β-actin.) Extended data Harvard Dataverse: Real Time PCR for ABCB11 and few NRs. [105]https://doi.org/10.7910/DVN/AOYKY7 ^[106]36. This project contains the following extended data: * Supp-Table-1-Dysregulated genes [107]GSE70179, GEO2R, NCBI. (Differentially expressed genes * Supp-Table-2-Gene ontology analysis, DAVID. (Gene ontology analysis of Data are available under the terms of the [108]Creative Commons Zero "No rights reserved" data waiver (CC0 1.0 Public domain dedication). Funding Statement The corresponding author (Sanal MG) acknowledges the Science and Engineering Research Board (SERB), Government of India (ECR/2015/000275) and the Department of Biotechnology (DBT), Government of India (BT/PR15116/MED/31/334/2016) for a limited financial support for approximately 18 months. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. [version 1; peer review: 1 approved References