SHU, L; Hoo, RLC; WU, X; PAN, Y; LEE, PC; CHEONG, LY; Bornstein, SR; Rong, X; Gua, J; Xu, A. Citation Nature Communications, 2017, v. 8, p.

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Title mediates adaptive thermogenesis by promoting intracellular activation of thyroid hormones in brown adipocytes Author(s) SHU, L; Hoo, RLC; WU, X; PAN, Y; LEE, PC; CHEONG, LY; Bornstein, SR; Rong, X; Gua, J; Xu, A Citation Nature Communications, 7, v., p. 7:- Issued Date 7 URL http://hdl.handle.net/7/77 Rights This work is licensed under a Creative Commons Attribution- NonCommercial-NoDerivatives. International License.

Received Jun Accepted Dec Published 7 Jan 7 DOI:./ncomms7 OPEN mediates adaptive thermogenesis by promoting intracellular activation of thyroid hormones in brown adipocytes Lingling Shu,,, Ruby L.C. Hoo,,, Xiaoping Wu,, Yong Pan,, Ida P.C. Lee,, Lai Yee Cheong,, Stefan R. Bornstein, Xianglu Rong 5, Jiao Guo 5 & Aimin Xu,, The adipokine adipocyte fatty acid-binding protein () has been implicated in obesityrelated cardio-metabolic complications. Here we show that increases thermogenesis by promoting the conversion of T to T in brown adipocytes. We find that levels are increased in both white (WAT) and brown (BAT) adipose tissues and the bloodstream in response to thermogenic stimuli. knockout mice have reduced thermogenesis and whole-body energy expenditure after cold stress or after feeding a high-fat diet, which can be reversed by infusion of recombinant. Mechanistically, induces the expression of type-ii iodothyronine deiodinase in BAT via inhibition of the nuclear receptor liver X receptor a, thereby leading to the conversion of thyroid hormone from its inactive form T to active T. The thermogenic responses to T are abrogated in mice, but enhanced by. Thus, acts as a physiological stimulator of BAT-mediated adaptive thermogenesis. State Key Laboratory of Pharmaceutical Biotechnology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China. Department of Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China. Department of Pharmacology and Pharmacy, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China. Department of Medicine, University of Dresden, 7 Dresden, Germany. 5 Joint Laboratory of Guangdong and Hong Kong on Metabolic Diseases, Guangdong Pharmaceutical University, 5 Guangzhou, China. These authors contributed equally to this work. Correspondence and requests for materials should be addressed to R.L.C.H. (email: rubyhoo@hku.hk) or to A.X. (email: amxu@hku.hk). NATURE COMMUNICATIONS :7 DOI:./ncomms7 www.nature.com/naturecommunications

Obesity, which is caused by an extended energetic imbalance between energy intake and energy expenditure, is an important risk factor for type diabetes and cardiovascular diseases. Although the main function of white adipose tissue (WAT) is to store excess energy, brown adipose tissue (BAT), which is characterized by multi-locular oil vacuoles, high mitochondrial content and the presence of unique mitochondrial inner membrane protein uncoupling protein- (UCP-), dissipates energy as heat. Thus, BAT-mediated adaptive thermogenesis can be considered a defense mechanism that protects the organism against hypothermia or excessive weight gain in response to low temperature, or excess nutrient supply. Accumulating evidence suggests that enhancing organismal thermogenesis is a promising therapy to combat obesity. Adaptive thermogenesis is primarily regulated by sympathetic nervous system (SNS), which heavily innervates interscapular BAT. When the SNS is activated, catecholamines are released from sympathetic nerve endings and activate b-adrenoceptors on adipocytes, leading to an increase of intracellular cyclic adenosine monophosphate (camp) level. Elevated camp activates protein kinase A (PKA), which induces UCP- expression and activity. Activated PKA also promotes lipolysis via stimulating hormone sensitive lipase (HSL) to provide free fatty acids (FFAs) as energy substrate for b-oxidation in mitochondria and UCP- expression 5. Thyroid hormones also contribute to adaptive thermogenesis in BAT by coordinating with SNS to induce expression of thermogenic genes. Intracellular conversion of thyroxine (T) into bioactive,,5-triiodothyronine (T) by type II iodothyronine deiodinase (D) is required to activate the transcriptional program of thermogenic genes 7. Other hormones, produced by various tissues, that have also been shown to induce BAT activity or browning of WAT include natriuretic peptides, fibroblast growth factor (ref. 9), irisin, adipocyte-secreted leptin, adiponectin and several type II immune cytokines (IL, IL and IL) (refs 5). The adipokine adipocyte fatty acid-binding protein (, also known as FABP or ap) is abundantly expressed in adipocytes, but also produced in macrophages 7, endothelial cells and glial cells 9. functions as a lipid chaperone that regulates trafficking, fluxes and signalling of FFAs, and has an important role in linking lipid metabolism with inflammation. Although was originally identified as an abundant cytoplasmic protein in adipocytes, a portion of is released into bloodstream and acts as a humoral factor to regulate glucose and lipid metabolism,. Circulating is elevated in obese individuals and correlates positively with the features of the metabolic syndrome, and the incidence of atherosclerosis and cardiovascular diseases. Interestingly, knockout () mice are protected against high-fat diet (HFD)-induced metabolic dysfunction but exhibit increased adiposity comparing with their wild-type () littermates. RNAi-mediated germline knockdown of leading to a partial loss of in mice also increases the susceptibility to diet-induced obesity. Elevated expression is observed in BAT of hibernating animals and cold-induced rodents 5,. Expression of messenger RNA (mrna) is also increased together with other thermogenic genes in BAT and WAT of HFD-induced UCP- deficient mice, suggesting that might mediate a compensatory mechanism to maintain energy homeostasis 7. A recent study demonstrated that ablation of both and epidermal-fabp (E-FABP) impairs adaptive thermogenesis in mice in response to fasting and cold stress. However, the underlying mechanism whereby regulates energy metabolism remains elusive. In this study, we found that the obese mice have a marked attenuation of both HFD- and cold-induced BAT activation and energy expenditure, and this phenotype could be reversed by replenishment of recombinant (r). Mechanistically, we uncovered a role of in promoting the intracellular conversion of T to T in BAT, and show that this is mediated in part by facilitating the transport of circulating FFAs released from WAT to BAT, which in turn enhances thermogenesis. Results mice are defective in adaptive thermogenesis. To explore the potential roles of in the regulation of energy metabolism, global knockout () mice were generated 9 and fed with standard chow (STC) or HFD. mice are more susceptible to diet-induced obesity as compared with their littermates (Fig. a). After feeding with HFD for weeks, body weight of mice was significantly increased by.±% and the body weight gain in mice was even more drastic (B.7±.5%) when compared with their respective STC-fed controls (Supplementary Fig. a). Body composition analysis showed no obvious difference in either lean mass or body fluid between mice and controls on either STC or HFD. By contrast, the fat mass in HFD-fed mice was.-folds higher than the littermates (Supplementary Fig. b). This was further confirmed by dissection of mice showing a significant expansion in most of the fat pads in HFD-induced mice when compared with the respective controls (Supplementary Fig. c). No significant difference was observed in the weight of internal organs between or mice. The weight of liver was even lighter in mice (Supplementary Fig. d). Notably, there was no difference in the calorie intake between and mice when fed with either STC or HFD (Supplementary Fig. e). Consistent with the previous study, mice exhibited an improved metabolic profile as indicated by the significant alleviation of HFD-induced glucose intolerance and insulin resistance (Supplementary Fig. f h), a markedly reduced serum insulin and glucose levels, lipid profiles and a significantly higher adiponectin level compared with controls (Supplementary Fig. i m). Since deficiency does not affect calorie intake, we next investigated whether HFD-induced morbid obesity in mice was attributed to attenuated energy expenditure. The whole-body oxygen consumption (VO ) was comparable between STC-fed and mice (Fig. b), while mice fed with HFD for weeks displayed a significantly lower oxygen consumption compared with the relative controls (Fig. c). HFD-induced mice displayed a higher respiratory exchange ratio (Fig. d). In addition, glucose uptake in soleus muscle and liver was also significantly increased in mice when compared with their littermates (Supplementary Fig. n), suggesting that mice prefer to utilize carbohydrate rather than fatty acid as energy substrate. There was no obvious difference in locomotory activity (Fig. e) between HFD-induced and mice. To further verify the role of in adaptive thermogenesis, HFD-fed and mice were housed at C for h. Rectal temperature was dropped from B7 C to C in the first h in both the groups. Afterwards, the rectal temperature of mice maintained at B C while that of littermates gradually increased and significantly higher than that of mice after prolonged cold exposure (Fig. f). Furthermore, mice exhibited a significantly less fat loss compared with controls after cold exposure for NATURE COMMUNICATIONS :7 DOI:./ncomms7 www.nature.com/naturecommunications

a -STC -STC b VO ( ml h kg lean mass ) 5 -STC -STC VO ( ml h kg lean mass ) 5 -STC -STC 9: : : 9: : : : : 5: 9: : : 9: : : : : 5: c VO ( ml h kg lean mass ) 9: : : 9: : : : : 5: 9: : : 9: : : : : 5: VO ( ml h kg lean mass ) d RER (VO VCO )....7.7.7 e f g XAMB (counts) Rectal temperature ( C) 7 5 Time (h) Total fat loss (g).5..... Figure deficiency impairs adaptive thermogenesis in mice. (a) Representative photos of male -week-old mice and their littermates fed with either standard chow (STC) or high-fat diet (HFD) for weeks (n ¼ ). (b,c) Oxygen consumption (VO ) of the mice fed with (b) STC or (c) HFD for weeks (n ¼ ). (d) Respiratory exchange rate (RER) and (e) locomotory activity (XAMB) of above mice fed with HFD for weeks (n ¼ ). (f) Rectal temperature and (g) fat mass loss of or mice fed with HFD for weeks followed by cold exposure ( C) for h (n ¼ ). Data are represented as mean±s.e.m. Po.5, Po., Po. (Student s t-test). h (Fig. g). Taken together, these findings suggest that the morbidly obese phenotype of HFD-induced mice is attributed to the impaired adaptive thermogenesis. exhibited a similar cold-induced expression of UCP- and thermogenic genes in the subcutaneous fat as that in the littermates (Supplementary Fig. ). deficiency impairs BAT recruitment in mice. Brown adipose tissue (BAT) is the major organ responsible for adaptive thermogenesis. We next examined the impact of deficiency in BAT recruitment in response to HFD and cold exposure. STC-fed and mice showed comparable BAT morphology, while HFD-fed mice displayed larger lipid droplets but reduced multi-locular structures comparing with controls (Fig. a, top). When exposed to C for h, size and number of lipid droplets in HFD-fed mice were decreased more apparently than those in mice (Fig. a, bottom). This was confirmed by measurement of triglyceride levels in BAT (Fig. b). HFD or cold exposure induced approximately a fourfold increase of UCP- expression in BAT of mice, whereas deficiency significantly attenuated cold- and HFD-induced expression of UCP- (Fig. c e). Consistently, in response to HFD or cold challenge, mice exhibited compromised induction in the expression of thermogenic genes (PGC-a and Cidea) (Fig. f,g) while the expression of membrane fatty acid transporters such as CD and fatty acid transporter protein were induced to a similar levels in both types of mice (Supplementary Fig. ). Notably, mice facilitates the transportation of FFAs into BAT. is not only a cytoplasmic protein, but also present in the circulation. We next investigated the roles of circulating in thermogenesis. Circulating in C57BL/N mice was progressively elevated upon feeding with HFD, and this change was accompanied by increased level of FFAs (Fig. a,b). When C57BL/N mice were subjected to acute cold exposure, both circulating and FFAs were increased to a peak level in h, and gradually declined to a basal level (Fig. c,d). Similar results were observed in mice treated with the b-adrenergic receptor agonist norepinephrine (Fig. e,f), suggesting that circulating may be released simultaneously with FFAs upon thermogenic stimulation. Notably, abundance also increased markedly in WAT of C57BL/N mice in response to HFD or cold exposure (Supplementary Fig. ), suggesting that WAT may be the main source of elevated circulating and FFAs. Therefore, we next tested whether promotes adaptive thermogenesis by facilitating the transport of FFAs into BAT. Infusion of H-palmitate in C57BL/N mice followed by co-immunoprecipitation with anti- antibody revealed that serum could form complex with circulating NATURE COMMUNICATIONS :7 DOI:./ncomms7 www.nature.com/naturecommunications

a c d UCP- β-tubulin e C C C C UCP- β-tubulin -STC -STC -STC -STC - C - C - C - C KDa 5 KDa 5 UCP- band intensity UCP- band intensity 5 -STC -STC STC HFD C C b Relative mrna level Relative mrna level Triglceride level (mg dl mg ) f g UCP- intensity (fold change) -STC C C C C -STC STC HFD 5 Cidea PGC-α C C PGC-α Relative mrna level Relative mrna level -STC -STC Cidea Figure deficiency impedes HFD- and cold-induced activation of BAT in mice. Male -week-old and their littermates were fed with either STC or HFD for weeks and subjected to room temperature ( C) or cold exposure ( C) for h. (a) Haematoxylin and eosin (H&E) staining, (b) triglyceride levels, (c) immunohistochemistry (IHC) staining and densitometry analysis (right panel) for UCP- in brown adipose tissue (BAT) of mice. Scale bar, mm, with magnification of. Representative images from three independent experiments are shown (n ¼ ). (d,e) BAT isolated from above mice (d) fed with STC or HFD for weeks or (e) exposed to C or C for h were subjected to immunoblotting using an antibody against UCP-, b-tubulin as indicated. Right panels are the band intensity of UCP- relative to b-tubulin and expressed as arbitrary units (n ¼ ). (f,g) The mrna abundance of the thermogenic genes in BAT of above mice (f) fed with STC or HFD for weeks or (g) exposed to C or C for h (n ¼ ). Uncropped western blot images are shown in Supplementary Fig.. Data are represented as mean±s.e.m. Po.5, Po. (one-way analysis of variance with Bonferroni correction for multiple comparisons). FFAs (Fig. g). In vivo radioisotopic tracing showed that uptake of H-palmitate in BAT and WAT of mice were significantly lower than that in their littermates (Fig. h) while replenishment with r, but not its mutant RQ which does not have binding capacity to FFAs, significantly enhanced the uptake of H-palmitate in BAT and WAT (to a much lower extent) in both and mice (Fig. h,i). This was further confirmed by the result of in vivo BODIPY-FA fluorescence chasing experiment (Supplementary Fig. 5a,b). Similarly, BODIPY-FA uptake was markedly attenuated in -deficient primary brown adipocytes, while pre-incubation of BODIPY-FA with r enhanced uptake of FFAs in both deficient- and adipocytes (Fig. j). Furthermore, r exhibited a higher efficiency than the classical FFA carrier bovine serum albumin (BSA) in promoting FFA uptake in -deficient adipocytes (Fig. k). Fluorescent-labelled r entered adipocytes together with BODIPY-FA simultaneously while no fluorescent signal was detected in the control in which no r was added (Fig. l). Replenishment of r but not its mutant RQ significantly increased the FFA level in BAT and this change was accompanied by a decreased FFA level in NATURE COMMUNICATIONS :7 DOI:./ncomms7 www.nature.com/naturecommunications

WAT (Supplementary Fig. 5c) implicating that acts as a FFA chaperone in transporting FFAs released from WAT to BAT. Notably, a significant portion of fluorescent-labelled r administered through tail vein injection was delivered to BAT and WAT (to a lower extent). Cold exposure further enhanced the accumulation of r in the BAT (Supplementary Fig. 5d,e). Furthermore, pre-incubation of palmitate with r enhanced palmitate-induced oxygen consumption rate (OCR) in -deficient adipocytes (Fig. m). Taken together, these data suggest that exogenous facilitates the uptake of circulating FFAs into brown adipocytes to enhance its utilization. enhances energy expenditure in mice. To further determine whether circulating promotes adaptive thermogenesis, r or its mutant RQ was continuously delivered into the circulation of -week HFD-fed mice for a period of weeks during which the whole-body energy expenditure was measured. r and a (ng ml ), b FFA (mm).... c (ng ml ) d FFA (mm)... Time (week).. Time (week) Time (h) Time (h) e (ng ml ) NE Time (h) f FFA (mm). NE.... Time (h) g Total IgG KDa 5 CPMA (fold change) IgG r h CPMA mg protein,,5, 5 - - BAT -r -r WAT i CPMA mg protein,,5, 5 - - BAT -RQ -RQ WAT j RFU ( ) μg protein..5..5. r k CPMA ( ) μg protein BSA r l BODIPY-FA+rA FABP BODIPY-FA (control) min min min 5 min Bright field r BODIPY-FA Merge m OCR (pmol min μg μl ) OCR (pmol min μg μl ) PA Oligomycin 5 5 7 9 9 Time (min) r PA+r FCCP PA r PA+r R/A NATURE COMMUNICATIONS :7 DOI:./ncomms7 www.nature.com/naturecommunications 5

its mutant RQ were detectable in a comparable level in the circulation (Fig. a), BAT and WAT (Supplementary Fig. a,b). The whole-body energy expenditure was significantly increased by.5-folds in r-treated mice compared with -treated mice (Fig. b,c). The mice infused with the mutant RQ also showed an increase of oxygen consumption, but only to an approximately half extent as that of mice infused with r (Fig. b,c). Notably, infusion of r or RQ caused a modest decrease in body weight and fat mass, whereas the calorie intake was not affected (Supplementary Fig. c,d). To evaluate the effect of in modulating BAT recruitment, mice infused with the above proteins were subjected to C for h. r significantly increased the body temperature of mice (Fig. d), suggesting an improved cold tolerance. However, this effect on cold tolerance was significantly attenuated in mutant RQ-infused mice (Fig. d). There was a remarkable increase of coldinduced multi-locular structures and upregulated UCP- expression in BAT of r-infused mice (Fig. e,f), and were accompanied by a significantly elevated expression of thermogenic genes (PGC- a, Cidea and Dio) (Fig. g) comparing to the -infused control mice. However, the potency of the mutant RQ in inducing the expression of UCP- and other thermogenic genes (except Dio) were significantly lower than r (Fig. f,g). Consistently, infusion with r or RQ to and mice also modestly enhanced BAT recruitment at C but such an effect was much lower than their corresponding mice at C (Supplementary Fig. e g and Supplementary Fig. 7). Notably, there was no obvious change in glucose tolerance, insulin levels and insulin sensitivity (as determined by the insulin resistance index) in these recombinant proteins-infused mice comparing to the -infused mice (Supplementary Fig. a c,f h). The inflammatory status in the peripheral tissues was not altered in these mice (Supplementary Fig. d,e,i,j). Taken together, these data suggest that the fatty acid binding capacity of is at least partially contributed to its ability for the enhancement of thermogenesis. However, the mutant RQ was unable to increase FFA uptake while it could still partially reverse the impairment of adaptive thermogenesis in mice, indicating that there may be an additional mechanism contributing to the ability of in promoting thermogenesis. deficiency impairs conversion of T to T in BAT. To explore additional mechanism whereby regulates adaptive thermogenesis, we investigated whether deficiency altered SNS activity. Oxygen consumption of and mice on STC or HFD were comparable in response to norepinephrine (Supplementary Fig. 9a,b). Likewise, norepinephrine-induced circulating FFA levels were similar between HFD-induced and mice (Supplementary Fig. 9c). HFD-induced expression of b adrenergic receptor (ADRB) and the activation of tyrosine hydroxlase in BAT were significantly increased to a similar level in both types of mice (Supplementary Fig. 9d,e). These data suggest that deficiency does not attenuate SNS activity and lipolytic machinery in mice. Since SNS and thyroid hormones regulate adaptive thermogenesis cooperatively, we evaluated whether deficiency impedes the activation of thyroid hormones. There was no difference in circulating T or T levels between mice and their littermates fed with either STC or HFD (Fig. 5a,b). T is the major form of thyroid hormone in blood while it has to be converted to the activated form T within its target tissues. T levels in BAT of mice were increased significantly upon HFD feeding or cold exposure while this induction was abrogated in deficient BAT (Fig. 5c,d). To investigate the effect of in intracellular conversion of thyroid hormones, HFD-induced and mice were supplemented with or T for 5 consecutive days followed by cold exposure for h. Supplementation of T enhanced cold-induced energy expenditure in mice, whereas such an effect of T administration was significantly attenuated in mice (Fig. 5e). However, energy expenditure induced by supplementation of T was comparable between and mice (Fig. 5f), implicating that deficiency abolished T to T conversion in BAT. More multilocular structures and elevated UCP- expression were observed in BAT of mice treated with either T or T (Fig. 5g,h). However, treatment with T, but not T, induced such changes in mice (Fig. 5g,h). Similar results were observed in T- or T-treated and mice under C (Supplementary Fig. a d), although the magnitude of these changes was much smaller compared with those at C. The body weight, body composition and calorie intake were not altered in both types of mice under these circumstances (Supplementary Fig. e h). Consistently, systemic supplementation with T markedly increased T levels in BAT of both genotypes (Fig. 5i), while treatment with T could only increase T levels in BAT of mice but not in mice (Fig. 5j), suggesting that is required for conversion of T to T within BAT. Figure Circulating facilitates the uptake of free fatty acid into adipocytes. (a) Circulating and (b) FFA profile of male -week-old C57BL/N mice fed with HFD for weeks (n ¼ ). (c) Circulating and (d) FFA level of male -week-old C57BL/N mice during cold exposure ( C) for h (n ¼ ). (e) Circulating and (f) FFA level of male -week-old C57BL/N mice intraperitoneally injected with norepinephrine (NE; mg kg ) or (vehicle) for h under fasting condition (n ¼ ). (g) Co-immunoprecipitation (Co-IP) of and H-palmitate in serum of male -week-old C57BL/N mice after administration of H-palmitate ( mci) for h. Right panel is the H-palmitate radioactivity of the co-immunoprecipitated protein (n ¼ ). (h,i) H-palmitate uptake in BAT and WAT of -week-old mice and their littermates infused with or (h) recombinant (r; mgh )or(i) mutant RQ ( mgh )(n ¼ ). (j) BODIPY-FA uptake in or -deficient brown adipocytes treated with or r ( mgml ) for min (min) (n ¼ ). (k) H-palmitate uptake in -deficient adipocytes incubated with, bovine serum albumin (BSA; mgml ) or r ( mgml )(n ¼ ). (l) In vitro fluorescent imaging analysis of brown adipocytes treated with BODIPY-FA ( mm) with or without pre-incubation with fluorescent-labelled r ( mgml ). Images were taken at 5, and min after treatment. Control image was taken at min in which -deficient brown adipocytes were incubated with BODIPY-FA without pre-incubation with r. Scale bar, mm, with magnification of. Representative images from three independent experiments are shown (n ¼ ). (m) Oxygen consumption rate (OCR) and its mean value (lower panel) of -deficient brown adipocytes treated with palmitate (PA: nm) with or without pre-incubation with r ( mgml )(n ¼ ). CPMA, count per minutes for beta particles; RFU, relative fluorescence units; OCR, oxygen consumption rate; FCCP, carbonyl cyanide- -(trifluoromethoxy) phenylhydrazone; R/A, rotenone/antimycin A. Uncropped image for co-immunoprecipitation is shown in Supplementary Fig.. Data are represented as mean±s.e.m. Po.5, Po., Po. (Student s t-test (a g), one-way analysis of variance with Bonferroni correction for multiple comparisons (h k,m)). NATURE COMMUNICATIONS :7 DOI:./ncomms7 www.nature.com/naturecommunications

: : 5: : : 5: a (ng ml ) r r RQ N.D. RQ b VO ( ml h kg lean mass ) 9 7 5 r RQ 9: : : 9: : : Protein infusion ( days) 9: : : 9: : : c e VO ( ml h kg lean mass ) H&E IHC of UCP- r RQ C r RQ d Rectal temperature ( C) UCP- intensity (fold change) 7 $ $ 5 # # Time (h) r RQ - C r- C RQ- C f UCP- β-tubulin C r RQ KDa 5 UCP- band intensity - C r- C RQ- C g Relative mrna level - C r- C RQ- C PGC-α Cidea Dio Figure enhances energy expenditure and BAT recruitment in mice. Male -week-old mice fed with HFD for weeks were infused with (vehicle), recombinant (r, mgh ) or mutant RQ ( mgh ) for days with or without subjected to cold exposure ( C). (a) Circulating r level and (b) oxygen consumption (VO ) of mice before or after infusion of recombinant proteins (n ¼ ). (c) Mean VO of above mice measured after infusion of recombinant proteins for days (n ¼ ). (d) Rectal temperature of above mice infused with r or RQ during cold exposure ( C) for h. (e) Haematoxylin and eosin staining and IHC staining of UCP- in BAT of mice after cold exposure for h, scale bar, mm; with magnification of. The right panel is the densitometry analysis for UCP-. Representative images from three independent experiments are shown (n ¼ ). (f) BAT isolated from above mice was subjected to immunoblotting using an antibody against UCP-, b-tubulin as indicated. The right panel is the band intensity of UCP- relative to b-tubulin (n ¼ ). (g) The mrna abundance of the thermogenic genes PGC-a, Cidea and Dio in BAT isolated from above mice (n ¼ ). CPMA, count per minutes for beta particles. N.D., not detected. Uncropped western blot images are shown in Supplementary Fig.. Data are represented as mean±s.e.m. Po.5, Po., Po., $r versus RQ, $o.5; #RQ versus, #Po.5 (One-way analysis of variance with Bonferroni correction for multiple comparisons). enhances T levels in BAT via LXRa-Dio pathway. Type II iodothyronine deiodinase (D), which is encoded by the Dio gene, is the key enzyme responsible for local T to T conversion 7,. Dio is downregulated by the nuclear receptor LXRa, while represses LXRa activity and expression in macrophages. Therefore, we investigated whether NATURE COMMUNICATIONS :7 DOI:./ncomms7 www.nature.com/naturecommunications 7

a b c Serum T (ng ml ) T level in BAT (ng mg ).5..5..5. STC STC STC HFD. HFD HFD.......... C C T Serum T (ng ml ) d e f g C VO ( ml h kg lean mass ) T T..5 UCP- intensity (fold change) h i j UCP- relative mrna level T C T T level in BAT (ng mg )..... T T level in BAT (ng mg ) VO ( ml h kg lean mass ).5..5..5..5. T level in BAT (ng mg ).95 T T T..... C T.7 Figure 5 deficiency impairs conversion of T to T in BAT of mice. (a) Circulating T and (b) T levels of male -week-old mice and littermates fed with STC or HFD for weeks as indicated in Fig. (n ¼ ). (c,d) T levels in BAT of male -week-old mice and littermates (c) fed with STC or HFD weeks or (d) subjected to cold exposure ( C) for h as indicated in Fig. (n ¼ ). Male -week-old and mice fed with HFD for weeks were supplemented with, T ( mgkg, 5 days) or T (5 mgkg, day) followed by cold exposure ( C) for h. (e,f) Energy expenditure of mice supplemented with (e) T or(f) T followed by cold exposure ( C) for h (n ¼ ). (g) Representative IHC staining and densitometry analysis (right panel) for UCP- in the BAT of mice. Scale bar, mm, with magnification of. Representative images from three independent experiments are shown (n ¼ ). (h) The mrna abundance of UCP- in BAT of above mice (n ¼ ). (i,j) T levels in BAT isolated from above and mice fed with HFD for weeks supplemented with (i) Tor(j) T followed by cold exposure ( C) for h (n ¼ ). Data are represented as mean±s.e.m. Po.5, Po. (one-way analysis of variance with Bonferroni correction for multiple comparisons). regulates the conversion of T to T via LXRa-Dio signalling pathway. HFD and cold exposure greatly induced the expression of and Dio in the BAT of mice, whereas this induction was obviously impaired in mice (Fig. a d). On the contrary, LXRa expression decreased substantially in mice in response to HFD or cold exposure, but its expression in mice was not altered (Fig. a d). Furthermore, treatment with r did not alter the gene expression of while it significantly suppressed LXRa but increased Dio expression in both primary -deficient and brown adipocytes (Fig. e). Treatment with the mutant RQ also showed similar effects on the gene expression in both deficient- and brown adipocytes (Supplementary Fig. ), but to a lesser extent compared with those treated with r. To assess whether represses LXRa activity, - or deficient primary brown adipocytes were treated with the LXRa agonist TO97 in the presence or absence of r followed by monitoring the expression of the downstream target genes of LXRa, including stearoyl- CoA desaturase (SCD-) and sterol regulatory element-binding transcription factor (SREBP-c),5. Treatment with TO97 NATURE COMMUNICATIONS :7 DOI:./ncomms7 www.nature.com/naturecommunications

a -STC -STC KDa b - C - C - C - C KDa 5 5 D 5 D 5 β-tubulin β-tubulin Band intensity -STC -STC N.D. N.D. D Band intensity - C - C - C - C N.D. N.D. D c d e Relative mran level -STC 5 N.D. -STC Dio Relative mran level 5 - C - C - C - C N.D. Dio p=.9 Relative mran level 5 - -r - -r Dio f Relative mran level 5 5 SCD- Relative mran level r TO+r r TO+r SREBP-c r TO TO+r r TO TO+r Relative mran level r TO TO+r Dio r TO TO+r Figure mediates expression of Dio via inhibition of LXRa. (a,b) BAT isolated from and mice (a) fed with STC or HFD for weeks or (b) subjected to room temperature ( C) or cold exposure ( C) for h as indicated in Fig. were subjected to immunoblotting using an antibody against, type II iodothyronine deiodinase (D), liver X receptor a (LXRa) and b-tubulin. The bar charts below are the band intensity of each protein relative to b-tubulin and expressed as arbitrary units, N.D., not detected (n ¼ ). (c,d) The mrna abundance of, Dio and LXRa in BAT of above and mice (c) fed with STC or HFD for weeks or (d) subjected to cold exposure ( C) for h (n ¼ ). (e) The mrna abundance of, LXRa and Dio in or -deficient primary brown adipocytes incubated with or recombinant (r, mgml ) for h (n ¼ ). (f) The mrna abundance of LXRa downstream target genes (SCD-, SREBP-c) and Dio in and -deficient primary brown adipocytes treated with or without LXRa agonist TO97 (TO; mm) and/or r ( mgml ) for h (n ¼ ). Uncropped western blot images are shown in Supplementary Fig.. Data are represented as mean±s.e.m. Po.5, Po. (One-way analysis of variance with Bonferroni correction for multiple comparisons). drastically increased the expression of SCD- and SREBP-c in primary brown adipocytes derived from both genotypes, which were greatly suppressed by co-treatment with r (Fig. f). Consistently, the downregulated expression of Dio by treatment with TO97 was significantly reversed by r (Fig. f), suggesting that increases Dio expression via inhibition of LXRa. promotes proteasomal degradation of LXRa. To further explore the potential mechanism whereby inhibits LXRa, deficient- and primary adipocytes were treated with the transcription inhibitor actinomycin D followed by measuring the mrna abundance of LXRa at different time points. deficiency did not have significant effect on the basal mrna level of LXRa. Furthermore, the mrna abundance of LXRa was gradually decreased to a similar extent in both and deficient adipocytes after treatment with actinomycin D (Fig. 7a), suggesting that does not alter the mrna stability of LXRa. We then examined if modulates the protein stability of LXRa using cycloheximide (a protein synthesis inhibitor) chase assay. The degradation of LXRa in deficient primary brown adipocytes after treatment with cycloheximide was significantly attenuated comparing to that of the adipocytes (Fig. 7b), suggesting that the presence of accelerates protein degradation of NATURE COMMUNICATIONS :7 DOI:./ncomms7 www.nature.com/naturecommunications 9

a % mrna 5 5 - - -act D -act D Time (h) b CHX GADPH KDa 5 levels relative to GADPH (% of time zero) 5 5 Time (h) c CHX+MG GADPH KDa 5 levels relative to GADPH (% of time zero) 5 5 Time (h) d CHX GADPH Ad-Luci Ad-AFABP KDa 5 levels relative to GADPH (% of time zero) 5 5 Ad-Luci Ad-AFABP Time (h) Figure 7 accelerates proteasomal degradation of LXRa. (a) Primary adipocytes derived from male -week-old mice or littermates were treated with actinomycin D (actd, mgml ) or vehicle (). The mrna level of LXRa was determined by real-time PCR at time points as indicated (n ¼ ). (b,c) Primary brown adipocytes derived from male -week-old mice or littermates were treated with (b) cycloheximide (CHX, 5 mgml )or(c) CHX (5 mgml ) together with MG ( mm) for different periods were subjected to immunoblotting using an antibody against LXRa, and GADPH as indicated (n ¼ ). (d) Primary brown adipocytes derived male -week-old mice or littermates were infected with adenovirus overexpressing (Ad-AFABP) or luciferase (Ad-Luci) for h, followed by treatment with CHX (5 mgml ) for,, and h, and then subjected to immunoblotting using an antibody against LXRa, and GADPH as indicated (n ¼ ). The right panel is the band intensity of LXRa normalized with GAPDH, and expressed as percentage relative to baseline ( h). Uncropped western blot images are shown in Supplementary Fig.. Data are represented as mean±s.e.m. Po.5, Po. (Students t-test). LXRa. Conversely, treatment of cycloheximide together with MG (an inhibitor that reduces proteasomal degradation of ubiquitin-conjugated proteins) blocked the degradation of LXRa in both and -deficient primary adipocytes (Fig. 7c). Furthermore, adenovirus-mediated overexpression of significantly enhanced the degradation of LXRa in deficient primary adipocytes comparing with its controls with overexpression of luciferase (Fig. 7d). Taken together, these data suggest that inhibits LXRa in part by promoting ubiquitination-dependent proteasomal degradation. restores T-induced energy expenditure in mice. To confirm the role of in intracellular conversion of T to T in BAT, HFD-fed and mice were infused with either r or (as vehicle), followed by subcutaneous injection of T for 5 consecutive days and cold exposure for another h (Fig. a). Energy expenditure increased significantly in T-treated mice comparing with vehicle-treated controls (Fig. b,c). Consistent with the above result (Fig. 5e), the oxygen consumption of T-treated mice was comparable to that of mice without T treatment, while replenishment of r together with T significantly increased oxygen consumption of mice similar to that in T-treated mice (Fig. b,c), suggesting that is essential for the effect of T on induction of energy expenditure in vivo. Moreover, T-induced increase in multi-locular cells and expression of UCP- in BAT was significantly augmented by infusion of r in mice (Fig. d). NATURE COMMUNICATIONS :7 DOI:./ncomms7 www.nature.com/naturecommunications

a b c Vehicle T T T 5 days, i.p. C h r VO ( ml h kg lean mass ) -vehicle -T -T r-ta C 9: : : 9: : : : : 9: : : 9: : : : : 5: VO ( ml h kg lean mass ) -vehicle -T -T r-t C C d C - vehicle - T - T r TA H&E UCP- intensity (fold change) IHC of UCP- T + + + r + e Relative mrna level..5..5 Dio UCP-. T + + + r + Relative mrna level T + + + r + Relative mrna level T + + + r + f g h Serum T level (ng ml )....... T + + + r + Serum T level (ng ml )... T + + + r + T level in BAT (ng mg ).. T + + + r + Figure enhances conversion of T to T and energy expenditure in mice. (a) Schematic diagram of the experimental procedure. Male -week-old mice and littermates fed with HFD for weeks were replenished with r ( mgh ) or for days. Mice were then subcutaneously injected with T ( mgkg ; 5 days) at the last 5 days of recombinant protein administration followed by cold exposure ( C) for h (n ¼ ). (b) Whole-body energy expenditure and (c) mean value of cold-induced energy expenditure of mice mentioned above (n ¼ ). (d) Representative H&E staining, IHC staining and densitometry analysis for the expression of UCP- (right panel) in BAT, scale bar, mm, with magnification of. Representative images from three independent experiments are shown (n ¼ ). (e) The mrna abundance of LXRa, Dio and UCP- in BAT of above mice (n ¼ ). Circulating levels of (f) T and (g) T and (h) T level in BAT of mice mentioned above (n ¼ ). Data are represented as mean±s.e.m. Po.5, Po. (one-way analysis of variance with Bonferroni correction for multiple comparisons.) In line with our in vitro findings (Figs and 7), replenishment with r significantly attenuated the expression of LXRa in mice, which was accompanied by enhanced T-induced expression of Dio and UCP- in BAT (Fig. e). Replenishment with r did not alter the circulating levels of T or T in mice (Fig. f,g). However, with the pre-treatment of T, the intracellular T level in BAT of mice infused with r was significantly elevated compared with mice infused with (Fig. h), indicating that controls the intracellular conversion of T to T in BAT. Similar results were also observed in T-treated and mice with or without replenishment with NATURE COMMUNICATIONS :7 DOI:./ncomms7 www.nature.com/naturecommunications

Circulation BAT T FFA Dio T HFD FFA FFA FFA FFA UCP- WAT r under room temperature ( C). Their body weight, body composition and calorie intake were not altered under these circumstances (Supplementary Fig. ). Discussion Previous studies showed that deficiency exacerbates diet-induced body weight gain in mice. Deletion of and E-FABP is also shown to impair thermogenesis in mice in response to cold stress under fasting state. Although the authors speculated that A/E-FABP may have a key role in facilitating FFA transport from circulation to BAT thus providing energy substrate for thermogenesis, this hypothesis was not experimentally validated. Thus, the role of and its underlying mechanism in adaptive thermogenesis remains poorly understood. In this study, we demonstrated that is a physiological regulator of adaptive thermogenesis in response to both HFD and cold exposure, through its intracellular actions to promote the activation of thyroid hormones and its endocrine actions to transport FFAs released from WAT to BAT for b-oxidation (Fig. 9). We observed a rapid elevation of in bloodstream and adipose tissues in response to cold and HFD challenges. A rapid release of from adipose tissues to circulation has also been observed in mice treated with the b -adrenergic receptor agonist CL- (ref. ), suggesting that is an immediate responder of various thermogenic stimuli. While BAT is a main site for adaptive thermogenesis by combustion of FFAs, WAT is a major supply for FFAs through HSL-mediated lipolysis of triglycerides stored in this tissue. Previous studies have demonstrated the role of in promoting lipolysis in WAT, by enhancing HSL activity,. However, its function in transport of FFAs is largely ignored, despite the fact that is a lipid-binding chaperone. While it is well known that triglyceride-rich lipoproteins are the primary transporters for delivery of FFAs in BAT 7, we here provided several lines of P HSL Cold Lipolysis FFA FFA Heat TG rich lipoproteins Figure 9 Mechanisms by which regulates adaptive thermogenesis. In response to cold challenge or HFD, is elevated in BAT, WAT and in the circulation. Elevated in BAT induces the expression of Dio via suppression of LXRa. Increased Dio promotes adaptive thermogenesis by enhancing conversion of T to T in BAT. In addition, elevated circulating facilitates the delivery of WAT-derived FFAs to BAT. Increased FFAs supply to BAT further induces the expression and activation of UCP- for thermogenesis. evidences demonstrating that the stimulatory effects of on adaptive thermogenesis are attributed in part to its ability in transporting FFAs released from WAT to BAT. First, the dynamic changes of circulating and FFAs levels are strikingly similar in response to thermogenic stimuli (Fig. ). Second, can complex with FFAs in the circulation (Fig. ). Third, r, but not its mutant RQ which loses the lipid-binding capacity, can directly stimulate the uptake of palmitate in primary brown adipocytes and promote energy expenditure (Fig. ). Fourth, the defective thermogenesis, impaired BAT activity and reduced FFA uptake into BAT in mice can be largely reversed by chronic administration of r into the circulation (Fig. ). In line with this notion, capillary endothelial is essential for FFA transport from the circulation into FFA-consuming tissues such as heart and skeletal muscle. It is worthy to note that although the abundance of is much lower than circulating FFAs, the equilibrium between FFAs and FABP is achieved rapidly within s at 7 C and within s at C, and possesses the fastest off-rate from its bound FFA comparing with intestinal-fabp and heart-fabp 9. Therefore, may have a complementary role with triglyceride-rich lipoproteins in delivery of FFAs into BAT, by facilitating the release of WAT FFAs into the circulation and transport of FFAs to BAT. Nevertheless, as is a cytoplasmic FFA chaperone, it may also facilitate the transportation of FFAs to mitochondria for b-oxidation. In line with our findings, other transporters of FFAs such as CD (ref. ) and fatty acid transport protein (ref. ), are also important in adaptive thermoregulation by facilitating FFA uptake into BAT. Furthermore, we uncovered the stimulatory effects of on intracellular conversion of T to T as another important mechanism for promoting adaptive thermogenesis. BAT with abundant expression of both a and b thyroid hormone receptors is a well-established target of thyroid hormone. The preponderance of thyroid hormones released from the thyroid glands into bloodstream is its inactive form T, which needs to be converted intracellularly by D into its bioactive metabolite T for further activation of thyroid hormone receptors. In BAT, thyroid hormones act coordinately with SNS to promote thermogenesis. Upon thermogenic stimuli, activation of SNS induces a marked elevation of D expression (approximately - to 5-fold) in BAT 7, which in turn converts T to T (ref. ). The elevated T further induces D expression in BAT, thereby forming a positive feedback loop to increase availability of T. On the other hand, T enhances the expression of b-adrenoceptors in both BAT and WAT 5, thus potentiating the stimulatory effects of catecholamines on thermogenesis in BAT. Activated thyroid hormone receptors also act directly to increase camp-mediated induction of the expression of UCP- gene and to induce the expression of a cluster of genes involved in mitochondrial biogenesis 7,. Our present study found that thermogenic stimuli (such as cold and HFD challenge)-induced expression of D and conversion of T to T in BAT were markedly decreased in mice. Furthermore, supplementation of T significantly stimulated cold-induced oxygen consumption and BAT activation in mice, but not in mice, although and mice were equally sensitive to norepinephrine-induced BAT activation and thermogenesis. In support of our conclusion, phenotypic changes of D mice are also strikingly similar to mice in our study, including diminished conversion of T to T in BAT, and impaired adaptive thermogenesis in response to cold challenge despite normal serum T levels 7. Our study demonstrated that the effects of on promoting D expression and T to T conversion were mediated NATURE COMMUNICATIONS :7 DOI:./ncomms7 www.nature.com/naturecommunications

by its suppression of LXRa, which is a nuclear receptor having a key role in regulating bile acid, glucose and lipid homeostasis 7. In BAT of mice, the impairment in cold-induced expression of D was accompanied by an attenuated reduction of LXRa. Vice versa, the effect of LXRa agonist TO97 on suppression of Dio in primary brown adipocytes was abrogated by treatment with r. Activation of LXRa suppresses the transcription of the Dio gene by binding to its promoter, thus reducing D-mediated T production in BAT. In line with our study, LXR a/b / mice display increased energy expenditure and UCP- expression in BAT while treatment with the LXR agonist GW95 exerted opposite effects. The expression of Dio is also sixfold higher in the LXRa / mice compared with their littermates. Furthermore, LXRs form complex with its co-factor, the receptor interacting protein, which competes with peroxisome proliferator-activated receptor g (PPARg) and peroxisome proliferator-activated receptor gamma coactivator -alpha (PGC-a) for the enhancer region of the UCP- gene promoter and represses the gene expression 9. Therefore, may also enhance UCP- expression through its suppressive effect on LXRa. Consistent with our findings, has been shown to downregulate LXRa activity in macrophages, leading to altered de novo lipogenesis and ER stress and exacerbated atherosclerosis. Furthermore, mediates ubiquitination and the subsequent proteasomal degradation of PPARg 5 and LXRa can be ubiquitinated by BRCA-associated Ring domain/ breast and ovarian cancer susceptibility and its stability and activity can be regulated by ubiquitination-mediated proteasomal degradation 5 suggesting that promotes ubiquitination-dependent proteasomal degradation of LXRa as one of the mechanisms by which suppresses LXRa. Further studies are needed to investigate how accelerates the proteosomal degradation of LXRa by modulating ubiquitination. Notably, is also a downstream target of LXRa activation 5, suggesting the existence of a negative feedback loop between and LXRa. It is also worthy to note that unsaturated FFAs can act as the suppressor of LXRa by preventing its binding to the target genes 5. As we showed that can form complex with circulating FFAs and facilitates their uptake into BAT, it is also possible that -mediated accumulation of intracellular unsaturated FFAs interferes with the binding of LXRa to its responsive element on Dio promoter, thereby increasing Dio expression in BAT. In addition, can modulate the activity of several transcription factors, including janus kinase and PPARg 5,, the latter of which is also a regulator of LXRa expression 5. Further investigations are warranted to explore the involvement of these transcription factors in mediating -mediated suppression of LXRa and subsequent induction of the Dio gene in BAT. While our present study showed the salutary effects of on prevention of obesity through promotion of adaptive thermogenesis in BAT, actions in other tissues have been shown to exacerbate obesity-related cardiometabolic disorder via its pro-inflammatory activities. In macrophages, potentiates toxic lipids- and endotoxininduced activation of inflammatory pathways (NF-kB and c-jun N-terminal kinase) and production of pro-inflammatory cytokines 57. Ablation of in macrophage alone is sufficient to render apolipoprotein E deficient mice refractory to spontaneous development of atherosclerosis 5. The secreted form of can also act on endothelium cells to induce endothelial dysfunction 59, on cardiomyocytes to suppress cardiac contraction and to mediate cardiac dysfunction during ischemic injury 9 and on hepatocytes to promote gluconeogenesis leading to altered glucose homeostasis. On the other hand, circulating may possess insulinotropic action mediating glucosestimulated insulin secretion of pancreatic b cells. Therefore, these findings, together with our present study, highlight the complex functions of in obesity and its associated cardiometabolic disorders due to its differential effects on various target tissues at different stages of the disease. It is likely that elevated under physiological stimuli (such as cold challenge) or early phase of obesity may serve as a defense response to promote adaptive thermogenesis through its actions in adipocytes. However, with the progression of obesity, prolonged and excessive increase of may exacerbate metabolic and cardiovascular disorders through its effects on non-adipose tissues, including macrophages, endothelium, cardiomyocytes and hepatocytes. The dual effects of on obesity and its associated medical complications are strikingly reminiscent of leptin, another adipocyte-secreted hormone that is elevated in both animals and human with obesity,. Intriguingly, leptin combats obesity through its hypothalamic actions to reduce food intake and its actions in brown adipocytes to enhance energy expenditure via promoting D activity and conversion of T to T in BAT. In contrast, excessive elevation of leptin can also cause cardiovascular diseases, liver inflammation and fibrosis through its actions on blood vessels, cardiomyocytes and liver 5,. In conclusion, our study demonstrated an important role of adipocyte-derived in adaptive thermogenesis, via its actions on conversion of T to T by modulating the LXRa-Dio signalling axis and facilitating the uptake of circulating FFAs into BAT. Notably, the pharmacological inhibitors of such as BMS9 (ref. 7) and the recent identified monoclonal antibody CA (ref. ) alleviate metabolic and cardiovascular disorders in animals. Our study suggests that global pharmacological inhibition of may not be an optimal therapeutic strategy for obesity-related cardiovascular and metabolic diseases due to the potential impairment of adaptive thermogenesis. Further investigations to dissect the structural and molecular basis underlying the differential effects of in different tissues are needed in order to design more effective therapeutic interventions for obesity and its related medical complication by targeting. Methods Animals. mice in C57BL/N background were generated using the same procedures as previously described 9. Age-matched male mice and their littermates were used in all the experiments of this study. Animals were allocated to their experimental group according to their genotypes. No randomization of mice was used. The investigators were not blinded to the experimental groups. Mice were housed in a temperature-controlled facility ( C, -hour light/dark cycle, 7% humidity). Four-week-old mice were weaned and fed with either STC (Purina, Framingham, MA, USA) or Western diet (D79B, Research Diet, USA) for or weeks. Body composition was determined bi-weekly by nuclear magnetic resonance (Bruker, minispec, Germany). All experimental protocols were approved by the Committee on the Use of Live Animals in Teaching and Research at the University of Hong Kong. Cold exposure. Male -week-old mice and their littermates fed with STC or HFD for weeks were provided with food and water ad libitum at C for or h. Rectal temperature was measured with Precision Thermometer (Thermo Scientific, MA, USA), and serum was collected at various time points via tail vein for lipid profile analysis. Glucose tolerance test and insulin tolerance test. For glucose tolerance test, male -week-old mice and their littermates fed with STC or HFD for weeks mice were housed in clean cages with fasting for h before intra-peritoneally injected with D-glucose ( g kg ). Blood glucose was monitored at,,,, 5,, 75 and 9 min after glucose injection. Male -week-old mice and their littermates fed with HFD for weeks infused with r ( mgh ) or its mutant RQ ( mgh ) were also subjected to glucose tolerance test. For insulin tolerance test, male -week-old mice and their littermates fed with STC or HFD for weeks mice were fasted NATURE COMMUNICATIONS :7 DOI:./ncomms7 www.nature.com/naturecommunications