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J. Biol. Chem., Vol. 279, Issue 15, 15130-15141, April 9, 2004

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In Vitro Suppression of the Lipogenic Pathway by the Nonnucleoside Reverse Transcriptase Inhibitor Efavirenz in 3T3 and Human Preadipocytes or Adipocytes^*

Khadija El Hadri, Martine Glorian, Christelle Monsempes, Marie-Noëlle Dieudonné¶, René Pecquery¶, Yves Giudicelli¶, Marise Andreani, Isabelle Dugail||, and Bruno Fève**

From the UMR CNRS 7079-Université Paris VI and ^||INSERM U465, Centre de Recherches Biomédicales des Cordeliers, 15 rue de l'Ecole de Médecine, 75006 Paris, France, and ^¶Service de Biochimie, Faculté de Médecine de Paris-Ile de France-Ouest, Université Versailles Saint-Quentin, Centre Hospitalier de Poissy, 78303 Poissy Cedex, France

A serious metabolic syndrome combining insulin-resistance, dyslipidemia, central adiposity, and peripheral lipoatrophy has arisen in HIV-infected patients receiving highly active antiretroviral therapy. The aim of this work was to examine the effects of the nonnucleoside reverse transcriptase inhibitor (NNRTI) efavirenz on adipocyte differentiation and metabolism. When induced to differentiate in the presence of efavirenz (5–50 µM), 3T3-F442A preadipocytes failed to accumulate cytoplasmic triacylglycerol droplets. This phenomenon was rapidly reversible and was also readily detectable in the 3T3-L1 preadipose cell line and in primary cultures of human preadipocytes. When applied to mature 3T3-F442A adipocytes, efavirenz induced a delayed and moderate reduction in cell triglyceride content. Measurement of [³H]deoxyglucose uptake, basal and agonist-stimulated lipolysis, and cell viability indicated that these pathways are not involved in efavirenz effects on triacylglycerol accumulation. By contrast, we found that the NNRTI induced a dramatic dose- and time-dependent decrease in gene and protein expression of the lipogenic transcription factor sterol regulatory element-binding protein-1c (SREBP-1c). Adipose conversion was only altered at the highest efavirenz concentrations, as suggested by the mild reduction in peroxisome proliferator-activated receptor- and CCAAT/enhancer-binding protein-. CCAAT/enhancer-binding protein- remained unchanged. The inhibition of SREBP-1c expression was accompanied by a sharp reduction in the expression of SREBP-1c target genes and in the adipocyte lipogenic activity in efavirenz-treated cells. Finally, the inhibitory effect of efavirenz on cell triglyceride accumulation was prevented by directly providing free fatty acids to the cells and was reversed by overexpression of a dominant positive form of SREBP-1c, reinforcing the implication of this transcription factor in the antilipogenic effect of the drug. When considered together, these results demonstrate for the first time that the NNRTI efavirenz induces a strong inhibition of the SREBP-1c-dependent lipogenic pathway that might contribute to adipose tissue atrophy.

Received for publication, November 25, 2003 , and in revised form, December 22, 2003.

^* This work was supported by grants from the Agence Nationale de Recherche sur le SIDA. 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.

These two authors contributed equally to this work.

^** To whom correspondence should be addressed. Tel.: 33-1-42-34-68-81; Fax: 33-1-46-34-59-73; E-mail: feve{at}bhdc.jussieu.fr.

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