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TM6SF2 is a regulator of liver fat metabolism influencing triglyceride secretion and hepatic lipid droplet content

Significance Genome-wide association studies have uncovered a genetic locus in chromosome 19 associated with the plasma triglyceride (TG) concentration, a risk factor for coronary heart disease. The identity and functional role of the gene responsible for this association is unknown. Gene expression analysis of 206 human liver samples led to the identification of transmembrane 6 superfamily member 2 (TM6SF2), a gene with hitherto unknown function, as the putative causal gene. Functional studies in human liver cells demonstrated that inhibition of TM6SF2 was associated with reduced secretion of TG-rich lipoproteins (TRLs) and increased cellular TG concentration, while TM6SF2 overexpression reduced cellular TG concentration. We conclude that TM6SF2 is a novel regulator of liver fat metabolism with opposing effects on the secretion of TRLs and hepatic TG content. Genome-wide association studies have identified a locus on chromosome 19 associated with plasma triglyceride (TG) concentration and nonalcoholic fatty liver disease. However, the identity and functional role of the gene(s) responsible for these associations remain unknown. Of 19 expressed genes contained in this locus, none has previously been implicated in lipid metabolism. We performed gene expression studies and expression quantitative trait locus analysis in 206 human liver samples to identify the putative causal gene. Transmembrane 6 superfamily member 2 (TM6SF2), a gene with hitherto unknown function, expressed predominantly in liver and intestine, was identified as the putative causal gene. TM6SF2 encodes a protein of 351 amino acids with 7–10 predicted transmembrane domains. Otherwise, no other protein features were identified which could help to elucidate the function of TM6SF2. Protein subcellular localization studies with confocal microscopy demonstrated that TM6SF2 is localized in the endoplasmic reticulum and the ER-Golgi intermediate compartment of human liver cells. Functional studies for secretion of TG-rich lipoproteins (TRLs) and lipid droplet content were performed in human hepatoma Huh7 and HepG2 cells using confocal microscopy and siRNA inhibition and overexpression techniques. In agreement with the genome-wide association data, it was found that TM6SF2 siRNA inhibition was associated with reduced secretion of TRLs and increased cellular TG concentration and lipid droplet content, whereas TM6SF2 overexpression reduced liver cell steatosis. We conclude that TM6SF2 is a regulator of liver fat metabolism with opposing effects on the secretion of TRLs and hepatic lipid droplet content.