A hormone complex of FABP4 and nucleoside kinases regulates islet function

KJ Prentice, J Saksi, LT Robertson, GY Lee, KE Inouye… - Nature, 2021 - nature.com
KJ Prentice, J Saksi, LT Robertson, GY Lee, KE Inouye, K Eguchi, A Lee, O Cakici…
Nature, 2021nature.com
The liberation of energy stores from adipocytes is critical to support survival in times of
energy deficit; however, uncontrolled or chronic lipolysis associated with insulin resistance
and/or insulin insufficiency disrupts metabolic homeostasis,. Coupled to lipolysis is the
release of a recently identified hormone, fatty-acid-binding protein 4 (FABP4). Although
circulating FABP4 levels have been strongly associated with cardiometabolic diseases in
both preclinical models and humans,,–, no mechanism of action has yet been described …
Abstract
The liberation of energy stores from adipocytes is critical to support survival in times of energy deficit; however, uncontrolled or chronic lipolysis associated with insulin resistance and/or insulin insufficiency disrupts metabolic homeostasis,. Coupled to lipolysis is the release of a recently identified hormone, fatty-acid-binding protein 4 (FABP4). Although circulating FABP4 levels have been strongly associated with cardiometabolic diseases in both preclinical models and humans, , –, no mechanism of action has yet been described, –. Here we show that hormonal FABP4 forms a functional hormone complex with adenosine kinase (ADK) and nucleoside diphosphate kinase (NDPK) to regulate extracellular ATP and ADP levels. We identify a substantial effect of this hormone on beta cells and given the central role of beta-cell function in both the control of lipolysis and development of diabetes, postulate that hormonal FABP4 is a key regulator of an adipose–beta-cell endocrine axis. Antibody-mediated targeting of this hormone complex improves metabolic outcomes, enhances beta-cell function and preserves beta-cell integrity to prevent both type 1 and type 2 diabetes. Thus, the FABP4–ADK–NDPK complex, Fabkin, represents a previously unknown hormone and mechanism of action that integrates energy status with the function of metabolic organs, and represents a promising target against metabolic disease.
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