A concerted action of multiple transcription factors is required to determine the specialized functions of adult differentiated cells. In recent years, there has been increasing knowledge of the transcription factors that control the differentiated function of insulin-producing β cells (
58,
70). Human genetics has provided an important source of information by uncovering transcription factor genes that are mutated in β-cell-deficient forms of diabetes (
40,
58,
71,
73). The most common form is due to mutations in
HNF1A, encoding hepatocyte nuclear factor-1α (also known as Hnf1α, Tcf1, or MODY3) (
73). Although first identified as a liver-specific transcription factor, heterozygous
HNF1A mutations in humans cause diabetes due to a progressive impairment of β-cell function (
7,
31,
65).
HNF1A-deficient patients eventually fail to respond to physiological stimuli, such as glucose, yet often retain a considerable ability to secrete insulin in response to sulfonylureas (
48).
Although
Hnf1a-haploinsufficient mice do not develop diabetes (
50),
Hnf1a-deficient mouse and cell line models have been invaluable for understanding the mechanisms underlying β-cell dysfunction. Reduced nutrient-induced insulin release in
Hnf1a-deficient models has thus been linked to impaired islet aerobic glucose metabolism (
13,
50,
66,
67). This in turn is associated with downregulation of selected genes involved in glucose metabolism, such as
Slc2a2 and
Pklr (
4,
46,
60). However, these are not rate-limiting steps in β-cell glycolysis, and therefore, the molecular defects that cause abnormal glucose metabolism in
Hnf1a-deficient β cells are currently not fully understood (
60).
The progressive β-cell phenotype of
HNF1A-deficient patients is consistent with a defect in β-cell growth (
16).
Hnf1a−/− mice have been shown to have small pancreatic islets, but it is not certain if this simply correlates with the markedly reduced size and lean mass of
Hnf1a−/− mice (
50). Moreover, there is no documented reduction of β-cell proliferation (
50). Severely reduced β-cell mass is observed in mice expressing a dominant-negative form of Hnf1α (
23,
72). However, this phenotype is much more severe than in
Hnf1a−/− mice and may involve the inhibition of other unknown regulatory functions since overexpression of wild-type Hnf1α causes a comparable phenotype (
34). The Hnf1α-dependent Tmem27 gene can positively regulate granule function and β-cell mass (
2,
17), although the final impact of defective
Tmem27 expression on islet mass in
Hnf1a-deficient mice has not been specifically studied. Therefore, several studies suggest that Hnf1α may regulate β-cell growth, yet this has not been conclusively demonstrated.
An important feature of human
HNF1A deficiency is that it causes a severe β-cell phenotype but only subtle abnormalities in other tissues where homozygous mutant mice have uncovered essential roles (
7,
30,
40,
49). This points to cell-specific functions that differ in their sensitivity to haploinsufficiency. Other observations also suggest that Hnf1α function differs in a fundamental manner in pancreatic islets and liver. For example, selected Hnf1α target genes (
Slc2a2,
Pklr, and
Hnf4a) are downregulated in
Hnf1a-deficient pancreatic islets but not in liver (
4,
46,
60). Furthermore, despite data suggesting that
Hnf1a deficiency causes defective β-cell growth,
HNF1A mutations paradoxically cause hepatocellular adenomas (
3). Little is known, however, concerning the extent to which Hnf1α function differs in these two tissues and the underlying transcriptional mechanisms.
A current limitation of our understanding of Hnf1α function is that the full spectrum of the genes that are regulated by Hnf1α in pancreatic islets remains unknown. Genome-wide expression profiling has been carried out with
Hnf1a−/− liver, showing that Hnf1α is involved in the regulation of several important hepatic functions, such as bile acid and cholesterol metabolism (
59). A large-scale analysis of promoter occupancy has revealed Hnf1α binding to a considerable number of genes in human islets and liver, pointing to a much broader role for Hnf1α than anticipated from candidate gene studies (
44). However, the functional significance of Hnf1α binding is unclear. Previous studies, for example, showed that although Hnf1α binds to
Slc2a2,
Pklr, and
Hnf4a in hepatocytes, this binding is not essential for their transcription in liver (
4,
46), raising the possibility that a significant number of Hnf1α-binding events are not essential for gene transcription.
To address these gaps in knowledge, we integrated the analysis of mRNA expression profiles in
Hnf1a−/− pancreatic islets and liver with the computational and experimental identification of direct Hnf1α targets. We show that Hnf1α regulates key pleiotropic functions in islets that are likely to be central in the pathophysiology of
HNF1A deficiency. Furthermore, we demonstrate that Hnf1α plays highly tissue-specific roles in islets and liver, with opposed effects on glucose metabolism and cell growth. We show that tumorigenesis is severely abrogated in
Hnf1a-deficient β cells expressing the large T antigen (TAg), thus providing a monogenic model that imparts opposed consequences on diabetes and cancer, supporting a notion implied by recent genetic findings in human polygenic type 2 diabetes (
20,
76). Finally, our analysis provides insights into how a single transcription factor regulates markedly different cell-specific genetic programs.