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Fu L, Guldiken N, Remih K, Karl AS, Preisinger C, Strnad P. Serum/Plasma Proteome in Non-Malignant Liver Disease. Int J Mol Sci 2024; 25:2008. [PMID: 38396688 PMCID: PMC10889128 DOI: 10.3390/ijms25042008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 01/31/2024] [Accepted: 02/03/2024] [Indexed: 02/25/2024] Open
Abstract
The liver is the central metabolic organ and produces 85-90% of the proteins found in plasma. Accordingly, the plasma proteome is an attractive source of liver disease biomarkers that reflects the different cell types present in this organ, as well as the processes such as responses to acute and chronic injury or the formation of an extracellular matrix. In the first part, we summarize the biomarkers routinely used in clinical evaluations and their biological relevance in the different stages of non-malignant liver disease. Later, we describe the current proteomic approaches, including mass spectrometry and affinity-based techniques, that allow a more comprehensive assessment of the liver function but also require complex data processing. The many approaches of analysis and interpretation and their potential caveats are delineated. While these advances hold the promise to transform our understanding of liver diseases and support the development and validation of new liver-related drugs, an interdisciplinary collaboration is needed.
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Affiliation(s)
- Lei Fu
- Department of Internal Medicine III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany; (L.F.); (N.G.); (K.R.); (A.S.K.)
| | - Nurdan Guldiken
- Department of Internal Medicine III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany; (L.F.); (N.G.); (K.R.); (A.S.K.)
| | - Katharina Remih
- Department of Internal Medicine III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany; (L.F.); (N.G.); (K.R.); (A.S.K.)
| | - Anna Sophie Karl
- Department of Internal Medicine III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany; (L.F.); (N.G.); (K.R.); (A.S.K.)
| | - Christian Preisinger
- Proteomics Facility, Interdisciplinary Centre for Clinical Research (IZKF), Medical School, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany;
| | - Pavel Strnad
- Department of Internal Medicine III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074 Aachen, Germany; (L.F.); (N.G.); (K.R.); (A.S.K.)
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2
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Gurbuz B, Guldiken N, Reuken P, Fu L, Remih K, Preisinger C, Brůha R, Leníček M, Petrtýl J, Reissing J, Aly M, Fromme M, Zhou B, Karkossa I, Schubert K, von Bergen M, Stallmach A, Bruns T, Strnad P. Biomarkers of hepatocellular synthesis in patients with decompensated cirrhosis. Hepatol Int 2023; 17:698-708. [PMID: 36652164 DOI: 10.1007/s12072-022-10473-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 12/24/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND AIM Since hepatocytes produce majority of serum proteins, patients with cirrhosis display substantial alterations in the serum proteome. The aim of the current study was to characterize these changes and to study the prognostic utility of hepatocellular proteins available in routine clinical testing. METHODS Sera from 29 healthy controls and 43 patients with cirrhosis were subjected to untargeted proteomic analysis. Unsupervised hierarchical clustering was performed with Perseus software and R. Ingenuity pathway analysis (IPA) suggested upstream regulators that were validated in liver tissues. The behavior and prognostic usefulness of selected biomarkers was investigated in 61 controls and 285 subjects with decompensated cirrhosis. RESULTS Proteomics uncovered 65 and 16 hepatocellular serum proteins that are significantly downregulated or upregulated in patients with cirrhosis vs. controls. Hierarchical clustering revealed two main clusters and six sub-clusters. IPA identified HNF4α and IL-6 as the two major upstream regulators that were confirmed by hepatic gene expression analyses. Among pseudocholinesterase, transferrin, transthyretin, albumin, and apolipoprotein AI (Apo-AI), Apo-AI was the best predictor of 90-days transplant-free survival (AUROC 0.678; p = 0.0001) and remained an independent predictor in multivariable Cox independently of the presence of acute-on-chronic liver failure. CONCLUSION Our study reveals cirrhosis-associated changes in hepatocellular serum proteins and underlying transcription factors. Serum apolipoprotein AI may constitute a useful prognostic adjunct in patients with decompensated cirrhosis.
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Affiliation(s)
- Berivan Gurbuz
- Department of Internal Medicine III and IZKF, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Nurdan Guldiken
- Department of Internal Medicine III and IZKF, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Philipp Reuken
- Department of Internal Medicine IV, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - Lei Fu
- Department of Internal Medicine III and IZKF, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.,Department of Science and Technology, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Guangxi Zhuang Autonomous Region, Nanning, 530011, China
| | - Katharina Remih
- Department of Internal Medicine III and IZKF, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Christian Preisinger
- Proteomics Facility, Interdisciplinary Center for Clinical Research (IZKF), University Hospital RWTH, Aachen, Germany
| | - Radan Brůha
- 4th Department of Internal Medicine, First Faculty of Medicine, General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - Martin Leníček
- Institute of Medical Biochemistry and Laboratory Diagnostics, First Faculty of Medicine, General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - Jaromír Petrtýl
- 4th Department of Internal Medicine, First Faculty of Medicine, General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - Johanna Reissing
- Department of Internal Medicine III and IZKF, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Mahmoud Aly
- Department of Internal Medicine III and IZKF, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.,Department of Medicine and Infectious Diseases, Faculty of Veterinary Medicine, University of Sadat, 12 City, Sadat City, Egypt
| | - Malin Fromme
- Department of Internal Medicine III and IZKF, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Biaohuan Zhou
- Department of Internal Medicine III and IZKF, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.,Department of Surgical Oncology, Fujian Provincial Hospital, Fuzhou, China
| | - Isabel Karkossa
- Department of Molecular Systems Biology, Helmholtz Centre for Environmental Research, Leipzig, Germany
| | - Kristin Schubert
- Department of Molecular Systems Biology, Helmholtz Centre for Environmental Research, Leipzig, Germany
| | - Martin von Bergen
- Department of Molecular Systems Biology, Helmholtz Centre for Environmental Research, Leipzig, Germany.,German Centre for Integrative Biodiversity Research, (iDiv) Halle-Jena-Leipzig, Leipzig, Germany.,Faculty of Life Sciences, Institute of Biochemistry, University of Leipzig, Leipzig, Germany
| | - Andreas Stallmach
- Department of Internal Medicine IV, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - Tony Bruns
- Department of Internal Medicine III and IZKF, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.,Department of Internal Medicine IV, Jena University Hospital, Friedrich Schiller University, Jena, Germany
| | - Pavel Strnad
- Department of Internal Medicine III and IZKF, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital Aachen, Pauwelsstraße 30, 52074, Aachen, Germany.
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Atkinson SR, Aly M, Remih K, Tyson LD, Guldiken N, Goldin R, Quaglia A, Thursz M, Strnad P. Serum keratin 19 (CYFRA21-1) is a prognostic biomarker in severe alcoholic hepatitis. Liver Int 2022; 42:1049-1057. [PMID: 35220651 DOI: 10.1111/liv.15218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 12/11/2021] [Accepted: 01/04/2022] [Indexed: 02/13/2023]
Abstract
BACKGROUND AND AIMS Up to 30% of patients with severe alcoholic hepatitis (sAH) die within 3 months of presentation. The degree of ductular reaction, characterized by accumulation of biliary and liver progenitor cells, confers a poor prognosis. Keratin fragments are established serological surrogates of liver injury and keratin 19 (K19) is a histological marker of the ductular reaction. We assessed the relationship between serum K19 levels (viz. CYFRA21-1), histology and outcome in patients with sAH. METHODS Serum CYFRA21-1 was quantified in pre-treatment serum samples from 824 patients enrolled in the STOPAH trial. The cohort was randomly divided into two groups to test mortality associations; histological analyses were performed using the 87 cases with suitable samples. RESULTS CYFRA21-1 levels were elevated in sAH and strongly predicted alcoholic steatohepatitis (ASH) on biopsy (area under the receiver operated characteristic [AUROC] 0.785 [95% Confidence Interval 0.602-0.967]) and 90-day survival (AUROC 0.684/0.693). The predictive ability of CYFRA21-1 was comparable with the model of end-stage liver disease (MELD) score and was independently associated with survival in multivariable analysis. CYFRA21-1 moderately correlated with hepatocellular injury markers M30/M65 but displayed a more robust predictive ability. A combination of MELD and CYFRA21-1 conferred a modest improvement in the AUROC value (0.731/0.743). CONCLUSIONS In sAH serum, CYFRA21-1 levels associate with the presence of ASH on biopsy and independently predict 90-day survival. As a single marker performance is comparable to established scoring systems. Therefore, CYFRA21-1, which is available in many clinical laboratories, may become a useful component of prognostic models.
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Affiliation(s)
- Stephen Rahul Atkinson
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Mahmoud Aly
- Medical Clinic III, Gastroenterology, Metabolic diseases and Intensive Care, University Hospital RWTH, Aachen, Germany
- Faculty of Veterinary Medicine, Department of Medicine and Infectious Diseases, University of Sadat City, Sadat City, Egypt
| | - Katharina Remih
- Medical Clinic III, Gastroenterology, Metabolic diseases and Intensive Care, University Hospital RWTH, Aachen, Germany
| | - Luke David Tyson
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Nurdan Guldiken
- Medical Clinic III, Gastroenterology, Metabolic diseases and Intensive Care, University Hospital RWTH, Aachen, Germany
| | - Robert Goldin
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Alberto Quaglia
- Institute of Liver Studies, King's College Hospital NHS Foundation Trust, London, UK
| | - Mark Thursz
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Pavel Strnad
- Medical Clinic III, Gastroenterology, Metabolic diseases and Intensive Care, University Hospital RWTH, Aachen, Germany
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Heinrichs D, Brandt EF, Fischer P, Köhncke J, Wirtz TH, Guldiken N, Djudjaj S, Boor P, Kroy D, Weiskirchen R, Bucala R, Wasmuth HE, Strnad P, Trautwein C, Bernhagen J, Berres ML. Unexpected Pro-Fibrotic Effect of MIF in Non-Alcoholic Steatohepatitis Is Linked to a Shift in NKT Cell Populations. Cells 2021; 10:252. [PMID: 33525493 PMCID: PMC7918903 DOI: 10.3390/cells10020252] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/20/2021] [Accepted: 01/22/2021] [Indexed: 12/29/2022] Open
Abstract
Macrophage migration inhibitory factor (MIF) is a pleiotropic inflammatory cytokine with anti-fibrotic properties in toxic liver injury models and anti-steatotic functions in non-alcoholic fatty liver disease (NAFLD) attributed to the CD74/AMPK signaling pathway. As NAFLD progression is associated with fibrosis, we studied MIF function during NAFLD-associated liver fibrogenesis in mice and men by molecular, histological and immunological methods in vitro and in vivo. After NASH diet feeding, hepatic Mif expression was strongly induced, an effect which was absent in Mif∆hep mice. In contrast to hepatotoxic fibrosis models, NASH diet-induced fibrogenesis was significantly abrogated in Mif-/- and Mif∆hep mice associated with a reduced accumulation of the pro-fibrotic type-I NKT cell subpopulation. In vitro, MIF skewed the differentiation of NKT cells towards the type-I subtype. In line with the murine results, expression of fibrosis markers strongly correlated with MIF, its receptors, and markers of NKT type-I cells in NASH patients. We conclude that MIF expression is induced during chronic metabolic injury in mice and men with hepatocytes representing the major source. In NAFLD progression, MIF contributes to liver fibrogenesis skewing NKT cell polarization toward a pro-fibrotic phenotype highlighting the complex, context-dependent role of MIF during chronic liver injury.
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Affiliation(s)
- Daniel Heinrichs
- Department of Internal Medicine III, RWTH Aachen University, 52074 Aachen, Germany; (D.H.); (E.F.B.); (P.F.); (J.K.); (T.H.W.); (N.G.); (D.K.); (H.E.W.); (P.S.); (C.T.)
| | - Elisa F. Brandt
- Department of Internal Medicine III, RWTH Aachen University, 52074 Aachen, Germany; (D.H.); (E.F.B.); (P.F.); (J.K.); (T.H.W.); (N.G.); (D.K.); (H.E.W.); (P.S.); (C.T.)
| | - Petra Fischer
- Department of Internal Medicine III, RWTH Aachen University, 52074 Aachen, Germany; (D.H.); (E.F.B.); (P.F.); (J.K.); (T.H.W.); (N.G.); (D.K.); (H.E.W.); (P.S.); (C.T.)
| | - Janine Köhncke
- Department of Internal Medicine III, RWTH Aachen University, 52074 Aachen, Germany; (D.H.); (E.F.B.); (P.F.); (J.K.); (T.H.W.); (N.G.); (D.K.); (H.E.W.); (P.S.); (C.T.)
| | - Theresa H. Wirtz
- Department of Internal Medicine III, RWTH Aachen University, 52074 Aachen, Germany; (D.H.); (E.F.B.); (P.F.); (J.K.); (T.H.W.); (N.G.); (D.K.); (H.E.W.); (P.S.); (C.T.)
| | - Nurdan Guldiken
- Department of Internal Medicine III, RWTH Aachen University, 52074 Aachen, Germany; (D.H.); (E.F.B.); (P.F.); (J.K.); (T.H.W.); (N.G.); (D.K.); (H.E.W.); (P.S.); (C.T.)
| | - Sonja Djudjaj
- Institute of Pathology, RWTH Aachen University, 52074 Aachen, Germany; (S.D.); (P.B.)
| | - Peter Boor
- Institute of Pathology, RWTH Aachen University, 52074 Aachen, Germany; (S.D.); (P.B.)
| | - Daniela Kroy
- Department of Internal Medicine III, RWTH Aachen University, 52074 Aachen, Germany; (D.H.); (E.F.B.); (P.F.); (J.K.); (T.H.W.); (N.G.); (D.K.); (H.E.W.); (P.S.); (C.T.)
| | - Ralf Weiskirchen
- Institute of Molecular Pathobiochemistry, Experimental Gene Therapy and Clinical Chemistry, RWTH University Hospital Aachen, 52074 Aachen, Germany;
| | - Richard Bucala
- Rheumatology Section of the Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520-8031, USA;
| | - Hermann E. Wasmuth
- Department of Internal Medicine III, RWTH Aachen University, 52074 Aachen, Germany; (D.H.); (E.F.B.); (P.F.); (J.K.); (T.H.W.); (N.G.); (D.K.); (H.E.W.); (P.S.); (C.T.)
| | - Pavel Strnad
- Department of Internal Medicine III, RWTH Aachen University, 52074 Aachen, Germany; (D.H.); (E.F.B.); (P.F.); (J.K.); (T.H.W.); (N.G.); (D.K.); (H.E.W.); (P.S.); (C.T.)
| | - Christian Trautwein
- Department of Internal Medicine III, RWTH Aachen University, 52074 Aachen, Germany; (D.H.); (E.F.B.); (P.F.); (J.K.); (T.H.W.); (N.G.); (D.K.); (H.E.W.); (P.S.); (C.T.)
| | - Jürgen Bernhagen
- Chair of Vascular Biology, Institute of Stroke and Dementia Research, LMU Klinikum, Lud-wig-Maximilian-University (LMU), 81377 Munich, Germany;
- Munich Cluster for Systems Neurology, 81377 Munich, Germany
| | - Marie-Luise Berres
- Department of Internal Medicine III, RWTH Aachen University, 52074 Aachen, Germany; (D.H.); (E.F.B.); (P.F.); (J.K.); (T.H.W.); (N.G.); (D.K.); (H.E.W.); (P.S.); (C.T.)
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5
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Hamesch K, Guldiken N, Aly M, Hüser N, Hartmann D, Rufat P, Ziol M, Remih K, Lurje G, Scheiner B, Trautwein C, Mandorfer M, Reiberger T, Mueller S, Bruns T, Nahon P, Strnad P. Serum keratin 19 (CYFRA21-1) links ductular reaction with portal hypertension and outcome of various advanced liver diseases. BMC Med 2020; 18:336. [PMID: 33176798 PMCID: PMC7661160 DOI: 10.1186/s12916-020-01784-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 09/16/2020] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Keratins (Ks) represent tissue-specific proteins. K18 is produced in hepatocytes while K19, the most widely used ductular reaction (DR) marker, is found in cholangiocytes and hepatic progenitor cells. K18-based serum fragments are commonly used liver disease predictors, while K19-based serum fragments detected through CYFRA21-1 are established tumor but not liver disease markers yet. Since DR reflects the severity of the underlying liver disease, we systematically evaluated the usefulness of CYFRA21-1 in different liver disease severities and etiologies. METHODS Hepatic expression of ductular keratins (K7/K19/K23) was analyzed in 57 patients with chronic liver disease (cohort i). Serum CYFRA21-1 levels were measured in 333 Austrians with advanced chronic liver disease (ACLD) of various etiologies undergoing hepatic venous pressure gradient (HVPG) measurement (cohort ii), 231 French patients with alcoholic cirrhosis (cohort iii), and 280 hospitalized Germans with decompensated cirrhosis of various etiologies (cohort iv). RESULTS (i) Hepatic K19 levels were comparable among F0-F3 fibrosis stages, but increased in cirrhosis. Hepatic K19 mRNA strongly correlated with the levels of other DR-specific keratins. (ii) In ACLD, increased serum CYFRA21-1 associated with the presence of clinically significant portal hypertension (CSPH; HVPG ≥ 10 mmHg) (OR = 5.87 [2.95-11.68]) and mortality (HR = 3.02 [1.78-5.13]; median follow-up 22 months). (iii) In alcoholic cirrhosis, elevated serum CYFRA21-1 indicated increased risk of death/liver transplantation (HR = 2.59 [1.64-4.09]) and of HCC (HR = 1.74 [1.02-2.96]) over the long term (median follow-up 73 months). (iv) In decompensated cirrhosis, higher serum CYFRA21-1 predicted 90-day mortality (HR = 2.97 [1.92-4.60]) with a moderate accuracy (AUROC 0.64), independently from established prognostic scores. CONCLUSIONS Hepatic K19 mRNA and serum CYFRA21-1 levels rise in cirrhosis. Increased CYFRA21-1 levels associate with the presence of CSPH and reliably indicate mortality in the short and long term independently of conventional liver biochemistry markers or scoring systems. Hence, the widely available serum CYFRA21-1 constitutes a novel, DR-related marker with prognostic implications in patients with different settings of advanced liver disease.
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Affiliation(s)
- Karim Hamesch
- Medical Clinic III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Nurdan Guldiken
- Medical Clinic III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Mahmoud Aly
- Medical Clinic III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany.,Department of Medicine and Infectious Diseases, Faculty of Veterinary Medicine, University of Sadat City, Sadat City, Egypt
| | - Norbert Hüser
- Department of Surgery, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, 81675, Munich, Germany
| | - Daniel Hartmann
- Department of Surgery, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, 81675, Munich, Germany
| | - Pierre Rufat
- AP-HP, Service d'Biostatistic Hopital Jean Verdier, Bondy, France
| | - Marianne Ziol
- Unité de Formation et de Recherche Santé Médecine et Biologie Humaine, Université Paris 13, Communauté d'Universités et Etablissements Sorbonne Paris Cité, Paris, France.,Centre de Recherche des Cordeliers, INSERM, Sorbonne Université, USPC, Université Paris Descartes, Université Paris Diderot, F-75006, Paris, France.,Centre de ressources biologiques du groupe hospitalier Paris-Seine-Saint-Denis, BB0033-00027, Hôpitaux Universitaires Paris-Seine-Saint-Denis, Assistance Publique Hôpitaux de Paris, Bondy, France
| | - Katharina Remih
- Medical Clinic III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Georg Lurje
- Department of Surgery and Transplantation, University Hospital Aachen, Aachen, Germany.,Department of Surgery, Campus Charité Mitte
- Campus Virchow-Klinikum-Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Bernhard Scheiner
- Vienna Hepatic Hemodynamic Lab, Division of Gastroenterology und Hepatology, Department of Internal Medicine III, Medical University Vienna, Vienna, Austria
| | - Christian Trautwein
- Medical Clinic III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Mattias Mandorfer
- Vienna Hepatic Hemodynamic Lab, Division of Gastroenterology und Hepatology, Department of Internal Medicine III, Medical University Vienna, Vienna, Austria
| | - Thomas Reiberger
- Vienna Hepatic Hemodynamic Lab, Division of Gastroenterology und Hepatology, Department of Internal Medicine III, Medical University Vienna, Vienna, Austria
| | - Sebastian Mueller
- Salem Medical Center and Center for Alcohol Research, University of Heidelberg, Heidelberg, Germany
| | - Tony Bruns
- Medical Clinic III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany.,Department of Internal Medicine IV, Gastroenterology, Hepatology and Infectious Diseases, Jena University Hospital, Jena, Germany.,Integrated Research and Treatment Center, Center for Sepsis Control and Care (CSCC), Jena University Hospital, Jena, Germany
| | - Pierre Nahon
- AP-HP, Service d'Hépatologie, Hopital Jean Verdier, Bondy, France.,Université Paris 13, Sorbonne Paris Cité, "Equipe labellisée Ligue Contre le Cancer", F-93206, Saint-Denis, France.,Inserm, UMR-1162, "Génomique fonctionnelle des tumeur solides", F-75000, Paris, France
| | - Pavel Strnad
- Medical Clinic III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany.
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6
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Puengel T, De Vos S, Hundertmark J, Kohlhepp M, Guldiken N, Pujuguet P, Auberval M, Marsais F, Shoji KF, Saniere L, Trautwein C, Luedde T, Strnad P, Brys R, Clément-Lacroix P, Tacke F. The Medium-Chain Fatty Acid Receptor GPR84 Mediates Myeloid Cell Infiltration Promoting Steatohepatitis and Fibrosis. J Clin Med 2020; 9:E1140. [PMID: 32316235 PMCID: PMC7231190 DOI: 10.3390/jcm9041140] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 04/05/2020] [Accepted: 04/14/2020] [Indexed: 12/17/2022] Open
Abstract
Medium-chain fatty acids (MCFAs) have been associated with anti-steatotic effects in hepatocytes. Expression of the MCFA receptor GPR84 (G protein-coupled receptor 84) is induced in immune cells under inflammatory conditions and can promote fibrogenesis. We aimed at deciphering the role of GPR84 in the pathogenesis of non-alcoholic steatohepatitis (NASH), exploring its potential as a therapeutic target. GPR84 expression is upregulated in liver from patients with non-alcoholic fatty liver disease (NAFLD), correlating with the histological degree of inflammation and fibrosis. In mouse and human, activated monocytes and neutrophils upregulate GPR84 expression. Chemotaxis of these myeloid cells by GPR84 stimulation is inhibited by two novel, small molecule GPR84 antagonists. Upon acute liver injury in mice, treatment with GPR84 antagonists significantly reduced the hepatic recruitment of neutrophils, monocytes, and monocyte-derived macrophages (MoMF). We, therefore, evaluated the therapeutic inhibition of GPR84 by these two novel antagonists in comparison to selonsertib, an apoptosis signal-regulating kinase 1 (ASK1) inhibitor, in three NASH mouse models. Pharmacological inhibition of GPR84 significantly reduced macrophage accumulation and ameliorated inflammation and fibrosis, to an extent similar to selonsertib. In conclusion, our findings support that GPR84 mediates myeloid cell infiltration in liver injury and is a promising therapeutic target in steatohepatitis and fibrosis.
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Affiliation(s)
- Tobias Puengel
- Department of Medicine III, RWTH-University Hospital Aachen, 52074 Aachen, Germany; (T.P.); (N.G.); (C.T.); (T.L.); (P.S.)
- Department of Hepatology & Gastroenterology, Charité University Medicine Berlin, 13353 Berlin, Germany; (J.H.); (M.K.)
| | - Steve De Vos
- Galapagos SA, 102 avenue Gaston Roussel, 93230 Romainville, France; (S.D.V.); (P.P.); (M.A.); (F.M.); (K.F.S.); (L.S.); (P.C.-L.)
- Galapagos NV, Generaal De Wittelaan L11 A3, 2800 Mechelen, Belgium;
| | - Jana Hundertmark
- Department of Hepatology & Gastroenterology, Charité University Medicine Berlin, 13353 Berlin, Germany; (J.H.); (M.K.)
| | - Marlene Kohlhepp
- Department of Hepatology & Gastroenterology, Charité University Medicine Berlin, 13353 Berlin, Germany; (J.H.); (M.K.)
| | - Nurdan Guldiken
- Department of Medicine III, RWTH-University Hospital Aachen, 52074 Aachen, Germany; (T.P.); (N.G.); (C.T.); (T.L.); (P.S.)
| | - Philippe Pujuguet
- Galapagos SA, 102 avenue Gaston Roussel, 93230 Romainville, France; (S.D.V.); (P.P.); (M.A.); (F.M.); (K.F.S.); (L.S.); (P.C.-L.)
| | - Marielle Auberval
- Galapagos SA, 102 avenue Gaston Roussel, 93230 Romainville, France; (S.D.V.); (P.P.); (M.A.); (F.M.); (K.F.S.); (L.S.); (P.C.-L.)
| | - Florence Marsais
- Galapagos SA, 102 avenue Gaston Roussel, 93230 Romainville, France; (S.D.V.); (P.P.); (M.A.); (F.M.); (K.F.S.); (L.S.); (P.C.-L.)
| | - Kenji F. Shoji
- Galapagos SA, 102 avenue Gaston Roussel, 93230 Romainville, France; (S.D.V.); (P.P.); (M.A.); (F.M.); (K.F.S.); (L.S.); (P.C.-L.)
| | - Laurent Saniere
- Galapagos SA, 102 avenue Gaston Roussel, 93230 Romainville, France; (S.D.V.); (P.P.); (M.A.); (F.M.); (K.F.S.); (L.S.); (P.C.-L.)
| | - Christian Trautwein
- Department of Medicine III, RWTH-University Hospital Aachen, 52074 Aachen, Germany; (T.P.); (N.G.); (C.T.); (T.L.); (P.S.)
| | - Tom Luedde
- Department of Medicine III, RWTH-University Hospital Aachen, 52074 Aachen, Germany; (T.P.); (N.G.); (C.T.); (T.L.); (P.S.)
| | - Pavel Strnad
- Department of Medicine III, RWTH-University Hospital Aachen, 52074 Aachen, Germany; (T.P.); (N.G.); (C.T.); (T.L.); (P.S.)
| | - Reginald Brys
- Galapagos NV, Generaal De Wittelaan L11 A3, 2800 Mechelen, Belgium;
| | - Philippe Clément-Lacroix
- Galapagos SA, 102 avenue Gaston Roussel, 93230 Romainville, France; (S.D.V.); (P.P.); (M.A.); (F.M.); (K.F.S.); (L.S.); (P.C.-L.)
| | - Frank Tacke
- Department of Hepatology & Gastroenterology, Charité University Medicine Berlin, 13353 Berlin, Germany; (J.H.); (M.K.)
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Guldiken N, Hamesch K, Schuller SM, Aly M, Lindhauer C, Schneider CV, Fromme M, Trautwein C, Strnad P. Mild Iron Overload as Seen in Individuals Homozygous for the Alpha-1 Antitrypsin Pi*Z Variant Does Not Promote Liver Fibrogenesis in HFE Knockout Mice. Cells 2019; 8:cells8111415. [PMID: 31717526 PMCID: PMC6912453 DOI: 10.3390/cells8111415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 11/04/2019] [Accepted: 11/06/2019] [Indexed: 12/31/2022] Open
Abstract
The presence of the homozygous 'Pi*Z' variant of alpha-1 antitrypsin (AAT) ('Pi*ZZ' genotype) predisposes to liver fibrosis development, but the role of iron metabolism in this process remains unknown. Therefore, we assessed iron metabolism and variants in the Homeostatic Iron Regulator gene (HFE) as the major cause of hereditary iron overload in a large cohort of Pi*ZZ subjects without liver comorbidities. The human cohort comprised of 409 Pi*ZZ individuals and 254 subjects without evidence of an AAT mutation who were recruited from ten European countries. All underwent a comprehensive work-up and transient elastography to determine liver stiffness measurements (LSM). The corresponding mouse models (Pi*Z overexpressors, HFE knockouts, and double transgenic [DTg] mice) were used to evaluate the impact of mild iron overload on Pi*Z-induced liver injury. Compared to Pi*Z non-carriers, Pi*ZZ individuals had elevated serum iron, transferrin saturation, and ferritin levels, but relevant iron overload was rare. All these parameters were higher in individuals with signs of significant liver fibrosis (LSM ≥ 7.1 kPa) compared to those without signs of significant liver fibrosis. HFE knockout and DTg mice displayed similar extent of iron overload and of fibrosis. Loss of HFE did not alter the extent of AAT accumulation. In Pi*ZZ individuals, presence of HFE mutations was not associated with more severe liver fibrosis. Taken together, Pi*ZZ individuals display minor alterations in serum iron parameters. Neither mild iron overload seen in these individuals nor the presence of HFE mutations (C282Y and H63D) constitute a major contributor to liver fibrosis development.
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Affiliation(s)
- Nurdan Guldiken
- Medical Clinic III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, D-52074 Aachen, Germany; (N.G.); (K.H.); (S.M.S.); (M.A.); (C.L.); (C.V.S.); (M.F.); (C.T.)
| | - Karim Hamesch
- Medical Clinic III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, D-52074 Aachen, Germany; (N.G.); (K.H.); (S.M.S.); (M.A.); (C.L.); (C.V.S.); (M.F.); (C.T.)
- Coordinating Center for Alpha-1 Antitrypsin Deficiency-Related Liver Disease of the European Reference Network on Hepatological Diseases (ERN RARE-LIVER) and the European Association for the Study of the Liver (EASL) Registry Group “Alpha-1 Liver”, Germany
| | - Shari Malan Schuller
- Medical Clinic III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, D-52074 Aachen, Germany; (N.G.); (K.H.); (S.M.S.); (M.A.); (C.L.); (C.V.S.); (M.F.); (C.T.)
| | - Mahmoud Aly
- Medical Clinic III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, D-52074 Aachen, Germany; (N.G.); (K.H.); (S.M.S.); (M.A.); (C.L.); (C.V.S.); (M.F.); (C.T.)
- Department of Medicine and Infectious Diseases, Faculty of Veterinary Medicine, University of Sadat City, Sadat City 32897, Egypt
| | - Cecilia Lindhauer
- Medical Clinic III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, D-52074 Aachen, Germany; (N.G.); (K.H.); (S.M.S.); (M.A.); (C.L.); (C.V.S.); (M.F.); (C.T.)
| | - Carolin V. Schneider
- Medical Clinic III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, D-52074 Aachen, Germany; (N.G.); (K.H.); (S.M.S.); (M.A.); (C.L.); (C.V.S.); (M.F.); (C.T.)
| | - Malin Fromme
- Medical Clinic III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, D-52074 Aachen, Germany; (N.G.); (K.H.); (S.M.S.); (M.A.); (C.L.); (C.V.S.); (M.F.); (C.T.)
| | - Christian Trautwein
- Medical Clinic III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, D-52074 Aachen, Germany; (N.G.); (K.H.); (S.M.S.); (M.A.); (C.L.); (C.V.S.); (M.F.); (C.T.)
- Coordinating Center for Alpha-1 Antitrypsin Deficiency-Related Liver Disease of the European Reference Network on Hepatological Diseases (ERN RARE-LIVER) and the European Association for the Study of the Liver (EASL) Registry Group “Alpha-1 Liver”, Germany
| | - Pavel Strnad
- Medical Clinic III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital RWTH Aachen, D-52074 Aachen, Germany; (N.G.); (K.H.); (S.M.S.); (M.A.); (C.L.); (C.V.S.); (M.F.); (C.T.)
- Coordinating Center for Alpha-1 Antitrypsin Deficiency-Related Liver Disease of the European Reference Network on Hepatological Diseases (ERN RARE-LIVER) and the European Association for the Study of the Liver (EASL) Registry Group “Alpha-1 Liver”, Germany
- Correspondence: ; Tel.: +49-(241)-80-35324; Fax: +49-(241)-80-82455
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8
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Hamesch K, Mandorfer M, Pereira VM, Moeller LS, Pons M, Dolman GE, Reichert MC, Schneider CV, Woditsch V, Voss J, Lindhauer C, Fromme M, Spivak I, Guldiken N, Zhou B, Arslanow A, Schaefer B, Zoller H, Aigner E, Reiberger T, Wetzel M, Siegmund B, Simões C, Gaspar R, Maia L, Costa D, Bento-Miranda M, van Helden J, Yagmur E, Bzdok D, Stolk J, Gleiber W, Knipel V, Windisch W, Mahadeva R, Bals R, Koczulla R, Barrecheguren M, Miravitlles M, Janciauskiene S, Stickel F, Lammert F, Liberal R, Genesca J, Griffiths WJ, Trauner M, Krag A, Trautwein C, Strnad P. Liver Fibrosis and Metabolic Alterations in Adults With alpha-1-antitrypsin Deficiency Caused by the Pi*ZZ Mutation. Gastroenterology 2019; 157:705-719.e18. [PMID: 31121167 DOI: 10.1053/j.gastro.2019.05.013] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Revised: 05/07/2019] [Accepted: 05/09/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Alpha-1 antitrypsin deficiency (AATD) is among the most common genetic disorders. Severe AATD is caused by a homozygous mutation in the SERPINA1 gene that encodes the Glu342Lys substitution (called the Pi*Z mutation, Pi*ZZ genotype). Pi*ZZ carriers may develop lung and liver diseases. Mutation-associated lung disorders have been well studied, but less is known about the effects in liver. We assessed the liver disease burden and associated features in adults with this form of AATD. METHODS We collected data from 554 Pi*ZZ adults (403 in an exploratory cohort, 151 in a confirmatory cohort), in 9 European countries, with AATD who were homozygous for the Pi*Z mutation, and 234 adults without the Pi*Z mutation (controls), all without pre-existing liver disease. We collected data on demographic parameters, comorbidities, lung- and liver-related health, and blood samples for laboratory analysis. Liver fibrosis was assessed non-invasively via the serum tests Aspartate Aminotransferase to Platelet Ratio Index and HepaScore and via transient elastography. Liver steatosis was determined via transient elastography-based controlled attenuation parameter. We performed histologic analyses of livers from transgenic mice that overexpress the AATD-associated Pi*Z variant. RESULTS Serum levels of liver enzymes were significantly higher in Pi*ZZ carriers vs controls. Based on non-invasive tests for liver fibrosis, significant fibrosis was suspected in 20%-36% of Pi*ZZ carriers, whereas signs of advanced fibrosis were 9- to 20-fold more common in Pi*ZZ carriers compared to non-carriers. Male sex; age older than 50 years; increased levels of alanine aminotransferase, aspartate aminotransferase, or γ-glutamyl transferase; and low numbers of platelets were associated with higher liver fibrosis burden. We did not find evidence for a relationship between lung function and liver fibrosis. Controlled attenuation parameter ≥280 dB/m, suggesting severe steatosis, was detected in 39% of Pi*ZZ carriers vs 31% of controls. Carriers of Pi*ZZ had lower serum concentrations of triglyceride and low- and very-low-density lipoprotein cholesterol than controls, suggesting impaired hepatic secretion of lipid. Livers from Pi*Z-overexpressing mice had steatosis and down-regulation of genes involved in lipid secretion. CONCLUSIONS In studies of AATD adults with the Pi*ZZ mutation, and of Pi*Z-overexpressing mice, we found evidence of liver steatosis and impaired lipid secretion. We identified factors associated with significant liver fibrosis in patients, which could facilitate hepatologic assessment and counseling of individuals who carry the Pi*ZZ mutation. ClinicalTrials.gov Number NCT02929940.
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Affiliation(s)
- Karim Hamesch
- Coordinating Center for Alpha1-Antitrypsin Deficiency-Related Liver Disease of the European Reference Network "Rare Liver" and the European Association for the Study of the Liver Registry Group "Alpha1-Liver," University Hospital Aachen, Aachen, Germany; Medical Clinic III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany
| | - Mattias Mandorfer
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University Vienna, Vienna, Austria
| | - Vítor M Pereira
- Department of Gastroenterology, Centro Hospitalar do Funchal, Madeira, Portugal
| | - Linda S Moeller
- Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark
| | - Monica Pons
- Liver Unit, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autonoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid, Spain
| | - Grace E Dolman
- Department of Hepatology, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge, UK
| | - Matthias C Reichert
- Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Carolin V Schneider
- Medical Clinic III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany
| | - Vivien Woditsch
- Medical Clinic III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany
| | - Jessica Voss
- Medical Clinic III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany
| | - Cecilia Lindhauer
- Medical Clinic III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany
| | - Malin Fromme
- Medical Clinic III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany
| | - Igor Spivak
- Medical Clinic III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany
| | - Nurdan Guldiken
- Medical Clinic III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany
| | - Biaohuan Zhou
- Medical Clinic III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany
| | - Anita Arslanow
- Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany; Department of Internal Medicine I, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Benedikt Schaefer
- Department of Internal Medicine I, Medical University Innsbruck, Innsbruck, Austria
| | - Heinz Zoller
- Department of Internal Medicine I, Medical University Innsbruck, Innsbruck, Austria
| | - Elmar Aigner
- Department of Internal Medicine I, Paracelsus Medical University, Salzburg, Austria
| | - Thomas Reiberger
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University Vienna, Vienna, Austria
| | - Martin Wetzel
- Department of Medicine I, Charité-Universitaetsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Britta Siegmund
- Department of Medicine I, Charité-Universitaetsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - Carolina Simões
- Gastroenterology Department, Centro Hospitalar Lisboa Norte, Lisbon, Portugal
| | - Rui Gaspar
- Gastroenterology Department, Centro Hospitalar de São João, Faculty of Medicine of Porto University, Porto, Portugal
| | - Luís Maia
- Gastroenterology Department, Centro Hospitalar do Porto, Porto, Portugal
| | - Dalila Costa
- Gastroenterology Department, Hospital de Braga, Braga, Portugal
| | - Mário Bento-Miranda
- Gastroenterology Department, Hospital Universitário de Coimbra, Coimbra, Portugal
| | - Josef van Helden
- Medical Care Centre, Dr Stein and Colleagues, Moenchengladbach, Germany
| | - Eray Yagmur
- Medical Care Centre, Dr Stein and Colleagues, Moenchengladbach, Germany
| | - Danilo Bzdok
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany; Jülich Aachen Research Alliance-Brain, Aachen, Germany
| | - Jan Stolk
- Clinic for Pulmonology, Leiden University Medical Center, Leiden, The Netherlands
| | - Wolfgang Gleiber
- Clinic for Pulmonology, University Hospital Frankfurt, Frankfurt, Germany
| | - Verena Knipel
- Department of Pneumology, Cologne Merheim Hospital, Kliniken der Stadt Köln gGmbH, Witten/Herdecke University, Faculty of Health/School of Medicine, Cologne, Germany
| | - Wolfram Windisch
- Department of Pneumology, Cologne Merheim Hospital, Kliniken der Stadt Köln gGmbH, Witten/Herdecke University, Faculty of Health/School of Medicine, Cologne, Germany
| | - Ravi Mahadeva
- Department of Respiratory Medicine, Cambridge National Institute for Health Research, Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - Robert Bals
- Department of Medicine V, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Rembert Koczulla
- Clinic for Pneumology, Marburg University Hospital, Marburg, Germany; Institute for Pulmonary Rehabilitation Research, Schoen Clinic Berchtesgadener Land, Member of the Deutsches Zentrum für Lungenforschung, Schönau am Königssee, Germany
| | - Miriam Barrecheguren
- Department of Pneumology, Vall d'Hebron University Hospital, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Barcelona, Spain
| | - Marc Miravitlles
- Department of Pneumology, Vall d'Hebron University Hospital, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Barcelona, Spain
| | - Sabina Janciauskiene
- Clinic for Pneumology, German Center for Lung Research, Medical University Hannover, Hannover, Germany
| | - Felix Stickel
- Department of Gastroenterology and Hepatology, University Hospital of Zurich, Zurich, Switzerland
| | - Frank Lammert
- Department of Medicine II, Saarland University Medical Center, Saarland University, Homburg, Germany
| | - Rodrigo Liberal
- Gastroenterology Department, Centro Hospitalar de São João, Faculty of Medicine of Porto University, Porto, Portugal
| | - Joan Genesca
- Liver Unit, Hospital Universitari Vall d'Hebron, Vall d'Hebron Research Institute, Universitat Autonoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas, Instituto de Salud Carlos III, Madrid, Spain
| | - William J Griffiths
- Department of Hepatology, Cambridge University Hospitals National Health Service Foundation Trust, Cambridge, UK
| | - Michael Trauner
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University Vienna, Vienna, Austria
| | - Aleksander Krag
- Department of Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark
| | - Christian Trautwein
- Coordinating Center for Alpha1-Antitrypsin Deficiency-Related Liver Disease of the European Reference Network "Rare Liver" and the European Association for the Study of the Liver Registry Group "Alpha1-Liver," University Hospital Aachen, Aachen, Germany; Medical Clinic III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany
| | - Pavel Strnad
- Coordinating Center for Alpha1-Antitrypsin Deficiency-Related Liver Disease of the European Reference Network "Rare Liver" and the European Association for the Study of the Liver Registry Group "Alpha1-Liver," University Hospital Aachen, Aachen, Germany; Medical Clinic III, Gastroenterology, Metabolic Diseases and Intensive Care, University Hospital Rheinisch-Westfälische Technische Hochschule Aachen, Aachen, Germany.
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Gross A, Pack LAP, Schacht GM, Kant S, Ungewiss H, Meir M, Schlegel N, Preisinger C, Boor P, Guldiken N, Krusche CA, Sellge G, Trautwein C, Waschke J, Heuser A, Leube RE, Strnad P. Desmoglein 2, but not desmocollin 2, protects intestinal epithelia from injury. Mucosal Immunol 2018; 11:1630-1639. [PMID: 30115995 DOI: 10.1038/s41385-018-0062-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 06/14/2018] [Accepted: 06/26/2018] [Indexed: 02/04/2023]
Abstract
Desmosomes are the least understood intercellular junctions in the intestinal epithelia and provide cell-cell adhesion via the cadherins desmoglein (Dsg)2 and desmocollin (Dsc)2. We studied these cadherins in Crohn's disease (CD) patients and in newly generated conditional villin-Cre DSG2 and DSC2 knockout mice (DSG2ΔIEC; DSC2ΔIEC). CD patients exhibited altered desmosomes and reduced Dsg2/Dsc2 levels. The intestines of both transgenic animal lines were histopathologically inconspicuous. However, DSG2ΔIEC, but not DSC2ΔIEC mice displayed an increased intestinal permeability, a wider desmosomal space as well as alterations in desmosomal and tight junction components. After dextran sodium sulfate (DSS) treatment and Citrobacter rodentium exposure, DSG2ΔIEC mice developed a more-pronounced colitis, an enhanced intestinal epithelial barrier disruption, leading to a stronger inflammation and activation of epithelial pSTAT3 signaling. No susceptibility to DSS-induced intestinal injury was noted in DSC2ΔIEC animals. Dsg2 interacted with the cytoprotective chaperone Hsp70. Accordingly, DSG2ΔIEC mice had lower Hsp70 levels in the plasma membrane compartment, whereas DSC2ΔIEC mice displayed a compensatory recruitment of galectin 3, a junction-tightening protein. Our results demonstrate that Dsg2, but not Dsc2 is required for the integrity of the intestinal epithelial barrier in vivo.
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Affiliation(s)
- Annika Gross
- Department of Medicine III and IZKF, University Hospital Aachen, Aachen, Germany
| | - Lotta A P Pack
- Department of Medicine III and IZKF, University Hospital Aachen, Aachen, Germany
| | - Gabriel M Schacht
- Department of Medicine III and IZKF, University Hospital Aachen, Aachen, Germany
| | - Sebastian Kant
- Institute of Molecular and Cellular Anatomy, RWTH Aachen University, Aachen, Germany
| | - Hanna Ungewiss
- Institute of Anatomy, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Michael Meir
- Department of Surgery I, University of Würzburg, Würzburg, Germany
| | - Nicolas Schlegel
- Department of Surgery I, University of Würzburg, Würzburg, Germany
| | | | - Peter Boor
- Institute of Pathology and Department of Nephrology, University Hospital Aachen, Aachen, Germany
| | - Nurdan Guldiken
- Department of Medicine III and IZKF, University Hospital Aachen, Aachen, Germany
| | - Claudia A Krusche
- Institute of Molecular and Cellular Anatomy, RWTH Aachen University, Aachen, Germany
| | - Gernot Sellge
- Department of Medicine III and IZKF, University Hospital Aachen, Aachen, Germany
| | - Christian Trautwein
- Department of Medicine III and IZKF, University Hospital Aachen, Aachen, Germany
| | - Jens Waschke
- Department of Surgery I, University of Würzburg, Würzburg, Germany
| | - Arnd Heuser
- Max-Delbrück-Center of Molecular Medicine, Berlin, Germany
| | - Rudolf E Leube
- Institute of Molecular and Cellular Anatomy, RWTH Aachen University, Aachen, Germany
| | - Pavel Strnad
- Department of Medicine III and IZKF, University Hospital Aachen, Aachen, Germany.
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10
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Levada K, Guldiken N, Zhang X, Vella G, Mo FR, James LP, Haybaeck J, Kessler SM, Kiemer AK, Ott T, Hartmann D, Hüser N, Ziol M, Trautwein C, Strnad P. Hsp72 protects against liver injury via attenuation of hepatocellular death, oxidative stress, and JNK signaling. J Hepatol 2018; 68:996-1005. [PMID: 29331340 PMCID: PMC9252261 DOI: 10.1016/j.jhep.2018.01.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 12/27/2017] [Accepted: 01/03/2018] [Indexed: 02/01/2023]
Abstract
BACKGROUND & AIMS Heat shock protein (Hsp) 72 is a molecular chaperone that has broad cytoprotective functions and is upregulated in response to stress. To determine its hepatic functions, we studied its expression in human liver disorders and its biological significance in newly generated transgenic animals. METHODS Double transgenic mice overexpressing Hsp72 (gene Hspa1a) under the control of a tissue-specific tetracycline-inducible system (Hsp72-LAP mice) were produced. Acute liver injury was induced by a single injection of acetaminophen (APAP). Feeding with either a methionine choline-deficient (MCD; 8 weeks) or a 3,5-diethoxycarbonyl-1,4-dihydrocollidine-supplemented diet (DDC; 12 weeks) was used to induce lipotoxic injury and Mallory-Denk body (MDB) formation, respectively. Primary hepatocytes were treated with palmitic acid. RESULTS Patients with non-alcoholic steatohepatitis and chronic hepatitis C infection displayed elevated HSP72 levels. These levels increased with the extent of hepatic inflammation and HSP72 expression was induced after treatment with either interleukin (IL)-1β or IL-6. Hsp72-LAP mice exhibited robust, hepatocyte-specific Hsp72 overexpression. Primary hepatocytes from these animals were more resistant to isolation-induced stress and Hsp72-LAP mice displayed lower levels of hepatic injury in vivo. Mice overexpressing Hsp72 had fewer APAP protein adducts and were protected from oxidative stress and APAP-/MCD-induced cell death. Hsp72-LAP mice and/or hepatocytes displayed significantly attenuated Jnk activation. Overexpression of Hsp72 did not affect steatosis or the extent of MDB formation. CONCLUSIONS Our results demonstrate that HSP72 induction occurs in human liver disease, thus, HSP72 represents an attractive therapeutic target owing to its broad hepatoprotective functions. LAY SUMMARY HSP72 constitutes a stress-inducible, protective protein. Our data demonstrate that it is upregulated in patients with chronic hepatitis C and non-alcoholic steatohepatitis. Moreover, Hsp72-overexpressing mice are protected from various forms of liver stress.
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Affiliation(s)
- Kateryna Levada
- Department of Internal Medicine III, RWTH University Hospital Aachen, Germany; Interdisciplinary Center for Clinical Research (IZKF), RWTH University Hospital Aachen, Germany; Center for Functionalized Magnetic Materials (FunMagMa), Immanuel Kant Baltic Federal University, Kaliningrad, Russian Federation
| | - Nurdan Guldiken
- Department of Internal Medicine III, RWTH University Hospital Aachen, Germany; Interdisciplinary Center for Clinical Research (IZKF), RWTH University Hospital Aachen, Germany
| | - Xiaoji Zhang
- Department of Internal Medicine III, RWTH University Hospital Aachen, Germany; Interdisciplinary Center for Clinical Research (IZKF), RWTH University Hospital Aachen, Germany
| | - Giovanna Vella
- Department of Internal Medicine III, RWTH University Hospital Aachen, Germany
| | - Fa-Rong Mo
- Department of Internal Medicine III, RWTH University Hospital Aachen, Germany
| | - Laura P James
- Arkansas Children's Hospital Research Institute and Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AK, USA
| | - Johannes Haybaeck
- Department of Pathology, Medical Faculty, Otto-von-Guericke University Magdeburg, Germany; Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Sonja M Kessler
- Department of Pharmacy, Pharmaceutical Biology, Saarland University, Saarbrücken, Germany
| | - Alexandra K Kiemer
- Department of Pharmacy, Pharmaceutical Biology, Saarland University, Saarbrücken, Germany
| | - Thomas Ott
- Core Facility Transgenic Animals, University of Tübingen, Tübingen, Germany
| | - Daniel Hartmann
- Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Norbert Hüser
- Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Marianne Ziol
- Pathology Department, GH Paris-Seine-Saint-Denis, APHP, Bondy, France; University Paris 13, Bobigny, France; Centre de Ressources Biologiques - Hôpital Jean Verdier, GH Paris-Seine-Saint-Denis, APHP, Bondy, France
| | - Christian Trautwein
- Department of Internal Medicine III, RWTH University Hospital Aachen, Germany
| | - Pavel Strnad
- Department of Internal Medicine III, RWTH University Hospital Aachen, Germany; Interdisciplinary Center for Clinical Research (IZKF), RWTH University Hospital Aachen, Germany.
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Levada K, Guldiken N, Vella G, James LP, Haybaeck J, Kiemer AK, Kessler SM, Trautwein C, Strnad P. Hsp72 overexpression protects from liver injury and hepatocellular death via attenuation of oxidative stress and JNK-signaling. Z Gastroenterol 2016. [DOI: 10.1055/s-0036-1597442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- K Levada
- University Hospital Aachen, Department of Medicine III and IZKF, Aachen, Germany
| | - N Guldiken
- University Hospital Aachen, Department of Medicine III and IZKF, Aachen, Germany
| | - G Vella
- University Hospital Aachen, Department of Medicine III and IZKF, Aachen, Germany
| | - LP James
- University of Arkansas for Medical Sciences, Arkansas Children's Hospital Research Institute and Department of Pediatrics, Little Rock, Arkansas, USA
| | - J Haybaeck
- Medical University Graz, Institute of Pathology, Graz, Austria
| | - AK Kiemer
- Saarland University, Department of Pharmacy, Pharmaceutical Biology, Saarbrücken, Germany
| | - SM Kessler
- Saarland University, Department of Pharmacy, Pharmaceutical Biology, Saarbrücken, Germany
| | - C Trautwein
- University Hospital Aachen, Department of Medicine III and IZKF, Aachen, Germany
| | - P Strnad
- University Hospital Aachen, Department of Medicine III and IZKF, Aachen, Germany
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Guldiken N, Kobazi Ensari G, Lahiri P, Couchy G, Preisinger C, Liedtke C, Zimmermann HW, Ziol M, Boor P, Zucman-Rossi J, Trautwein C, Strnad P. Keratin 23 is a stress-inducible marker of mouse and human ductular reaction in liver disease. J Hepatol 2016; 65:552-9. [PMID: 27151178 DOI: 10.1016/j.jhep.2016.04.024] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Revised: 04/06/2016] [Accepted: 04/23/2016] [Indexed: 01/09/2023]
Abstract
BACKGROUND & AIMS Keratins (K) constitute the epithelial intermediate filaments. Among them, K7/K19 are widely used markers of the regenerative liver response termed ductular reaction (DR) that consists of activated biliary epithelial cells (BECs) and hepatic progenitor cells (HPCs) and correlates with liver disease severity. In the present study we aimed to characterize K23 in the liver. METHODS We analyzed the expression and localization of K23 in the digestive system under basal conditions as well as in various human and mouse liver diseases/stress models. Cell culture studies were used to study factors regulating K23 expression. RESULTS In untreated mice, K23 was restricted to biliary epithelia. It was (together with K7/K19) markedly upregulated in three different DR/cholestatic injury models, i.e., multidrug resistance protein 2 (Mdr2) knockouts, animals treated with 3,5-diethoxycarbonyl-1,4-dihydrocollidine or subjected to bile duct ligation. K23 levels correlated with the DR marker Fn14 and immunofluorescence staining showed a distinct co-localization with K7/K19. In chronic human liver disease, K23 expression increased in patients with a more prominent inflammation/fibrosis. A dramatic upregulation (>200times) was observed in patients with acute liver failure (ALF) and end-stage primary biliary cholangitis (PBC). Patients with alcoholic liver cirrhosis displayed increased K23 serum levels. In primary hepatocytes as well as hepatobiliary cell lines, treatment with TNF-related weak inducer of apoptosis (TWEAK), and the type I acute phase inducer interleukin (IL)-1β but not the type II inducer IL-6 elevated K23 expression. CONCLUSIONS K23 represents a specific, stress-inducible DR marker, whose levels correlate with liver disease severity. K23 may represent a useful non-invasive DR marker. LAY SUMMARY Ductular reaction represents a basic response to liver injury and correlates with liver disease severity. Our study identifies K23 as a novel ductular reaction marker in mice and humans.
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Affiliation(s)
- Nurdan Guldiken
- Department of Internal Medicine III, RWTH University Hospital Aachen, Germany; Interdisciplinary Center for Clinical Research (IZKF), RWTH University Hospital Aachen, Germany
| | - Gokce Kobazi Ensari
- Department of Internal Medicine III, RWTH University Hospital Aachen, Germany
| | - Pooja Lahiri
- Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Gabrielle Couchy
- Inserm, UMR-1162, Génomique fonctionnelle des Tumeurs solides, Equipe Labellisée Ligue Contre le Cancer, Paris F-75010, France; Université Paris Descartes, Labex Immuno-Oncology, Sorbonne Paris Cité, F-75010 Paris, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, F-93000 Bobigny, France; Université Paris Diderot, IUH, F-75010 Paris, France
| | - Christian Preisinger
- Interdisciplinary Center for Clinical Research (IZKF), RWTH University Hospital Aachen, Germany
| | - Christian Liedtke
- Department of Internal Medicine III, RWTH University Hospital Aachen, Germany
| | | | - Marianne Ziol
- Université Paris 13, Sorbonne Paris Cité, UFR SMBH, F-93000 Bobigny, France; Pathology Department, GH Paris-Seine-Saint-Denis, APHP, Bondy, France; Centre de ressources biologiques BB-0033-00027 - Hôpital Jean Verdier, GH Paris-Seine-Saint-Denis, APHP, Bondy, France
| | - Peter Boor
- Department of Nephrology and Institute of Pathology, RWTH University Hospital Aachen, Germany
| | - Jessica Zucman-Rossi
- Inserm, UMR-1162, Génomique fonctionnelle des Tumeurs solides, Equipe Labellisée Ligue Contre le Cancer, Paris F-75010, France; Université Paris Descartes, Labex Immuno-Oncology, Sorbonne Paris Cité, F-75010 Paris, France; Université Paris 13, Sorbonne Paris Cité, UFR SMBH, F-93000 Bobigny, France; Université Paris Diderot, IUH, F-75010 Paris, France
| | - Christian Trautwein
- Department of Internal Medicine III, RWTH University Hospital Aachen, Germany
| | - Pavel Strnad
- Department of Internal Medicine III, RWTH University Hospital Aachen, Germany; Interdisciplinary Center for Clinical Research (IZKF), RWTH University Hospital Aachen, Germany.
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13
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Levada K, Guldiken N, Vella G, James LP, Haybaeck J, Kiemer AK, Kessler SM, Trautwein C, Strnad P. Hsp72 overexpression protects from drug-induced- and lipotoxic liver injury. Z Gastroenterol 2015. [DOI: 10.1055/s-0035-1568036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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14
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Guldiken N, Zhou Q, Kucukoglu O, Rehm M, Levada K, Gross A, Kwan R, James LP, Trautwein C, Omary MB, Strnad P. Human keratin 8 variants promote mouse acetaminophen hepatotoxicity coupled with c-jun amino-terminal kinase activation and protein adduct formation. Hepatology 2015; 62:876-86. [PMID: 25963979 PMCID: PMC4549164 DOI: 10.1002/hep.27891] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 04/15/2015] [Accepted: 05/03/2015] [Indexed: 12/21/2022]
Abstract
UNLABELLED Keratins 8 and 18 (K8/K18) are the intermediate filaments proteins of simple-type digestive epithelia and provide important cytoprotective function. K8/K18 variants predispose humans to chronic liver disease progression and poor outcomes in acute acetaminophen (APAP)-related liver failure. Given that K8 G62C and R341H/R341C are common K8 variants in European and North American populations, we studied their biological significance using transgenic mice. Mice that overexpress the human K8 variants, R341H or R341C, were generated and used together with previously described mice that overexpress wild-type K8 or K8 G62C. Mice were injected with 600 mg/kg of APAP or underwent bile duct ligation (BDL). Livers were evaluated by microarray analysis, quantitative real-time polymerase chain reaction, immunoblotting, histological and immunological staining, and biochemical assays. Under basal conditions, the K8 G62C/R341H/R341C variant-expressing mice did not show an obvious liver phenotype or altered keratin filament distribution, whereas K8 G62C/R341C animals had aberrant disulphide cross-linked keratins. Animals carrying the K8 variants displayed limited gene expression changes, but had lower nicotinamide N-methyl transferase (NNMT) levels and were predisposed to APAP-induced hepatotoxicity. NNMT represents a novel K8/K18-associated protein that becomes up-regulated after K8/K18 transfection. The more pronounced liver damage was accompanied by increased and prolonged JNK activation; elevated APAP protein adducts; K8 hyperphosphorylation at S74/S432 with enhanced keratin solubility; and prominent pericentral keratin network disruption. No differences in APAP serum levels, glutathione, or adenosine triphosphate levels were noted. BDL resulted in similar liver injury and biliary fibrosis in all mouse genotypes. CONCLUSION Expression of human K8 variants G62C, R341H, or R341C in mice predisposes to acute APAP hepatotoxicity, thereby providing direct evidence for the importance of these variants in human acute liver failure.
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Affiliation(s)
- Nurdan Guldiken
- IZKF and Department of Internal Medicine III, University Hospital Aachen, Germany,Department of Internal Medicine I, University Hospital Ulm, Ulm Germany
| | - Qin Zhou
- Department of Medicine, Palo Alto VA Medical Center, CA; and Stanford University Digestive Disease Center, USA
| | - Ozlem Kucukoglu
- Department of Internal Medicine I, University Hospital Ulm, Ulm Germany
| | - Melanie Rehm
- Department of Internal Medicine I, University Hospital Ulm, Ulm Germany
| | - Kateryna Levada
- IZKF and Department of Internal Medicine III, University Hospital Aachen, Germany
| | - Annika Gross
- IZKF and Department of Internal Medicine III, University Hospital Aachen, Germany
| | - Raymond Kwan
- Department of Molecular & Integrative Physiology, University of Michigan Medical School, and the VA Ann Arbor Health Care System, Ann Arbor, MI, USA
| | - Laura P. James
- Arkansas Children's Hospital Research Institute and Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Christian Trautwein
- IZKF and Department of Internal Medicine III, University Hospital Aachen, Germany
| | - M. Bishr Omary
- Department of Molecular & Integrative Physiology, University of Michigan Medical School, and the VA Ann Arbor Health Care System, Ann Arbor, MI, USA
| | - Pavel Strnad
- IZKF and Department of Internal Medicine III, University Hospital Aachen, Germany,Department of Internal Medicine I, University Hospital Ulm, Ulm Germany,To whom correspondence should be addressed. Corresponding author: Pavel Strnad, Department of Internal Medicine III and IZKF, University Hospital Aachen, Pauwelsstraße 30, D-52074 Aachen, Tel.: +49(241) 80-35324, Fax: +49(241) 80-82455,
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Chen Y, Guldiken N, Spurny M, Mohammed HHA, Haybaeck J, Pollheimer MJ, Fickert P, Gassler N, Jeon MK, Trautwein C, Strnad P. Loss of keratin 19 favours the development of cholestatic liver disease through decreased ductular reaction. J Pathol 2015; 237:343-54. [PMID: 26108453 DOI: 10.1002/path.4580] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 06/21/2015] [Accepted: 06/23/2015] [Indexed: 12/14/2022]
Abstract
Keratins (K) are cytoprotective proteins and keratin mutations predispose to the development of multiple human diseases. K19 represents the most widely used marker of biliary and hepatic progenitor cells as well as a marker of ductular reaction that constitutes the basic regenerative response to chronic liver injury. In the present study, we investigated the role of K19 in biliary and hepatic progenitor cells and its importance for ductular reaction. K19 wild-type (WT) and knockout (KO) mice were fed: (a) 3,5-diethoxycarbonyl-1,4-dihydrocollidine (DDC); (b) cholic acid (CA); (c) a choline-deficient, ethionine-supplemented (CDE) diet; or (d) were subjected to common bile duct ligation (CBDL). The bile composition, liver damage, bile duct proliferation, oval cell content and biliary fibrosis were analysed. In untreated animals, loss of K19 led to redistribution of the K network in biliary epithelial cells (BECs) but to no obvious biliary phenotype. After DDC feeding, K19 KO mice exhibited (compared to WTs): (a) increased cholestasis; (b) less pronounced ductular reaction with reduced ductular proliferation and fewer oval cells; (c) impaired Notch 2 signalling in BECs; (d) lower biliary fibrosis score and biliary bicarbonate concentration. An attenuated oval cell proliferation in K19 KOs was also found after feeding with the CDE diet. K19 KOs subjected to CBDL displayed lower BEC proliferation, oval cell content and less prominent Notch 2 signal. K19 deficiency did not change the extent of CA- or CBDL-induced liver injury and fibrosis. Our results demonstrate that K19 plays an important role in the ductular reaction and might be of importance in multiple chronic liver disorders that frequently display a ductular reaction.
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Affiliation(s)
- Yu Chen
- Department of Internal Medicine III and IZKF, RWTH Aachen, Germany.,Department of Internal Medicine I, University Medical Centre Ulm, Germany
| | - Nurdan Guldiken
- Department of Internal Medicine III and IZKF, RWTH Aachen, Germany.,Department of Internal Medicine I, University Medical Centre Ulm, Germany
| | - Manuela Spurny
- Department of Internal Medicine I, University Medical Centre Ulm, Germany
| | | | | | - Marion J Pollheimer
- Institute of Pathology, Medical University Graz, Austria.,Department of Internal Medicine, Medical University Graz, Austria
| | - Peter Fickert
- Institute of Pathology, Medical University Graz, Austria.,Department of Internal Medicine, Medical University Graz, Austria
| | - Nikolaus Gassler
- Institute of Pathology, University Hospital Aachen, RWTH Aachen, Germany
| | - Min Kyung Jeon
- Institute of Pathology, University Hospital Aachen, RWTH Aachen, Germany
| | | | - Pavel Strnad
- Department of Internal Medicine III and IZKF, RWTH Aachen, Germany.,Department of Internal Medicine I, University Medical Centre Ulm, Germany
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Szabo S, Wögenstein KL, Österreicher CH, Guldiken N, Chen Y, Doler C, Wiche G, Boor P, Haybaeck J, Strnad P, Fuchs P. Epiplakin attenuates experimental mouse liver injury by chaperoning keratin reorganization. J Hepatol 2015; 62:1357-66. [PMID: 25617501 PMCID: PMC4451473 DOI: 10.1016/j.jhep.2015.01.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 12/08/2014] [Accepted: 01/05/2015] [Indexed: 12/04/2022]
Abstract
BACKGROUND & AIMS Epiplakin is a member of the plakin protein family and exclusively expressed in epithelial tissues where it binds to keratins. Epiplakin-deficient (Eppk1(-/-)) mice displayed no obvious spontaneous phenotype, but their keratinocytes showed a faster keratin network breakdown in response to stress. The role of epiplakin in the stressed liver remained to be elucidated. METHODS Wild-type (WT) and Eppk1(-/-) mice were subjected to common bile duct ligation (CBDL) or fed with a 3,5-diethoxycarbonyl-1,4-dihydrocollidine (DDC)-containing diet. The importance of epiplakin during keratin reorganization was assessed in primary hepatocytes. RESULTS Our experiments revealed that epiplakin is expressed in hepatocytes and cholangiocytes, and binds to keratin 8 (K8) and K18 via multiple domains. In several liver stress models epiplakin and K8 genes displayed identical expression patterns and transgenic K8 overexpression resulted in elevated hepatic epiplakin levels. After CBDL and DDC treatment, Eppk1(-/-) mice developed a more pronounced liver injury and their livers contained larger amounts of hepatocellular keratin granules, indicating impaired disease-induced keratin network reorganization. In line with these findings, primary Eppk1(-/-) hepatocytes showed increased formation of keratin aggregates after treatment with the phosphatase inhibitor okadaic acid, a phenotype which was rescued by the chemical chaperone trimethylamine N-oxide (TMAO). Finally, transfection experiments revealed that Eppk1(-/-) primary hepatocytes were less able to tolerate forced K8 overexpression and that TMAO treatment rescued this phenotype. CONCLUSION Our data indicate that epiplakin plays a protective role during experimental liver injuries by chaperoning disease-induced keratin reorganization.
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Affiliation(s)
- Sandra Szabo
- Department of Biochemistry and Cell Biology, Max F. Perutz Laboratories, University of Vienna, Vienna, Austria
| | - Karl L Wögenstein
- Department of Biochemistry and Cell Biology, Max F. Perutz Laboratories, University of Vienna, Vienna, Austria
| | - Christoph H Österreicher
- Institute of Pharmacology, Center for Physiology and Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Nurdan Guldiken
- Department of Internal Medicine III and IZKF, University Hospital Aachen, Aachen, Germany
| | - Yu Chen
- Department of Internal Medicine III and IZKF, University Hospital Aachen, Aachen, Germany
| | - Carina Doler
- Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Gerhard Wiche
- Department of Biochemistry and Cell Biology, Max F. Perutz Laboratories, University of Vienna, Vienna, Austria
| | - Peter Boor
- Division of Nephrology and Institute of Pathology, RWTH University of Aachen, Aachen, Germany
| | | | - Pavel Strnad
- Department of Internal Medicine III and IZKF, University Hospital Aachen, Aachen, Germany
| | - Peter Fuchs
- Department of Biochemistry and Cell Biology, Max F. Perutz Laboratories, University of Vienna, Vienna, Austria.
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Guldiken N, Usachov V, Levada K, Trautwein C, Ziol M, Nahon P, Strnad P. Keratins 8 and 18 are type II acute-phase responsive genes overexpressed in human liver disease. Liver Int 2015; 35:1203-12. [PMID: 24930437 DOI: 10.1111/liv.12608] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 05/18/2014] [Indexed: 02/13/2023]
Abstract
BACKGROUND & AIMS Keratins (Ks) 7, 8, 18 and 19 constitute important markers and modifiers of liver disease. In mice, K8 and K18 are stress inducible and a dysregulated K8 > K18 stoichiometry predisposes to formation of Mallory-Denk bodies (MDBs), i.e. aggregates characteristic of chronic liver disorders such as alcoholic liver disease (ALD). In our study, we analyse the expression and the regulation of keratins in context of human liver disease. METHODS K7, K8, K18 and K19 mRNA levels were determined in liver biopsies from patients with ALD, non-alcoholic steatohepatitis (NASH), chronic hepatitis B (HBV), hepatitis C (HCV) and from control subjects. HepG2 and Hep3B cells were treated with IL-1β, IL-6 and TNF-α. Mice were injected with turpentine, an established IL-6 inducer. RESULTS K7, K8 and K18 were 1.5- to 3-fold upregulated in livers of ALD and HCV patients with a more active disease, but not in HBV/NASH subjects, while K19 was significantly elevated in all analysed disorders. K8 and K18 expression displayed a strong correlation (r = 0.89), but dysregulated levels with the K8 > K18 state were seen in ALD. All keratins were overexpressed in subjects with moderate vs. minimal inflammation, while K7, K8 and K18 were upregulated in patients with advanced liver fibrosis. In HepG2/Hep3B cells, IL-6 treatment but not IL-1β or TNF-α significantly increased K8 and K18 expression and elevated K18 levels were seen after turpentine injection. CONCLUSIONS Keratins represent type II acute-phase responsive genes overexpressed in specific human liver disorders. A K8 > K18 state occurs in ALD and predisposes to MDB formation.
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Affiliation(s)
- Nurdan Guldiken
- Department of Internal Medicine I, University Hospital Ulm, Ulm, Germany; IZKF and Department of Internal Medicine III, RWTH University Hospital Aachen, Aachen, Germany
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18
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Kucukoglu O, Guldiken N, Chen Y, Usachov V, El-Heliebi A, Haybaeck J, Denk H, Trautwein C, Strnad P. High-fat diet triggers Mallory-Denk body formation through misfolding and crosslinking of excess keratin 8. Hepatology 2014; 60:169-78. [PMID: 24519272 DOI: 10.1002/hep.27068] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2013] [Accepted: 02/06/2014] [Indexed: 01/11/2023]
Abstract
UNLABELLED Mallory-Denk bodies (MDBs) are protein aggregates consisting of ubiquitinated keratins 8/18 (K8/K18). MDBs are characteristic of alcoholic and nonalcoholic steatohepatitis (NASH) and discriminate between the relatively benign simple steatosis and the more aggressive NASH. Given the emerging evidence for a genetic predisposition to MDB formation and NASH development in general, we studied whether high-fat (HF) diet triggers MDB formation and liver injury in susceptible animals. Mice were fed a high-fat (HF) or low-fat (LF) diet plus a cofactor for MDB development, 3,5-diethoxycarbonyl-1,4-dihydrocollidine (DDC). Additionally, we fed nontransgenic and K8 overexpressing mice (K8tg) with the HF diet. The presence of MDB and extent of liver injury was evaluated using biochemical markers, histological staining, and immunofluorescence microscopy. In DDC-fed animals, an HF diet resulted in greater liver injury and up-regulation of inflammation-related genes. As a potential mechanism, K8/K18 accumulation and increased ecto-5'-nucleotidase (CD73) levels were noted. In the genetically susceptible K8tg mice, HF diet triggered hepatocellular injury, ballooning, apoptosis, inflammation, and MDB development by way of 1) decreased expression of the major stress-inducible chaperone Hsp72 with appearance of misfolded keratins; 2) elevated levels of the transglutaminase 2 (TG2); 3) increased K8 phosphorylation at S74 with subsequent TG2-mediated crosslinking of phosphorylated K8; and 4) higher production of the MDB-modifier gene CD73. CONCLUSION Our data demonstrate that HF diet triggers aggregate formation and development of liver injury in susceptible individuals through misfolding and crosslinking of excess K8.
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Affiliation(s)
- Ozlem Kucukoglu
- Department of Internal Medicine I, Center for Internal Medicine, University Medical Center Ulm, Ulm, Germany
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Strnad P, Nuraldeen R, Guldiken N, Hartmann D, Mahajan V, Denk H, Haybaeck J. Broad Spectrum of Hepatocyte Inclusions in Humans, Animals, and Experimental Models. Compr Physiol 2013; 3:1393-436. [DOI: 10.1002/cphy.c120032] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Mueller K, Sunami Y, Stuetzle M, Guldiken N, Kucukoglu O, Mueller S, Kulaksiz H, Schwarz P, Strnad P. CHOP-mediated hepcidin suppression modulates hepatic iron load. J Pathol 2013; 231:532-42. [PMID: 23749468 DOI: 10.1002/path.4221] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 05/16/2013] [Accepted: 06/05/2013] [Indexed: 12/22/2022]
Abstract
The liver is the central regulator of iron metabolism and accordingly, chronic liver diseases often lead to systemic iron overload due to diminished expression of the iron-regulatory hormone hepcidin. To study the largely unknown regulation of iron metabolism in the context of hepatic disease, we used two established models of chronic liver injury, ie repeated carbon tetrachloride (CCl(4)) or thioacetamide (TAA) injections. To determine the impact of CCAAT/enhancer-binding protein (C/EBP)-homologous protein (CHOP) on hepcidin production, the effect of a single TAA injection was determined in wild-type and CHOP knockout mice. Furthermore, CHOP and hepcidin expression was assessed in control subjects and patients with alcoholic liver disease. Both chronic injury models developed a distinct iron overload in macrophages. TAA-, but not CCl(4) - injected mice displayed additional iron accumulation in hepatocytes, resulting in a significant hepatic and systemic iron overload which was due to suppressed hepcidin levels. C/EBPα signalling, a known hepcidin inducer, was markedly inhibited in TAA mice, due to lower C/EBPα levels and overexpression of CHOP, a C/EBPα inhibitor. A single TAA injection resulted in a long-lasting (> 6 days) suppression of hepcidin levels and CHOP knockouts (compared to wild-types) displayed significantly attenuated hepcidin down-regulation in response to acute TAA administration. CHOP mRNA levels increased 5-fold in alcoholic liver disease patients versus controls (p < 0.005) and negatively correlated with hepcidin expression. Our results establish CHOP as an important regulator of hepatic hepcidin expression in chronic liver disease. The differences in iron metabolism between the two widely used fibrosis models likely reflect the differential regulation of hepcidin expression in human liver disease.
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Affiliation(s)
- Katrin Mueller
- Department of Internal Medicine I, University Hospital Ulm, Germany
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21
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Strnad P, Kucukoglu O, Lunova M, Guldiken N, Lienau TC, Stickel F, Omary MB. Non-coding keratin variants associate with liver fibrosis progression in patients with hemochromatosis. PLoS One 2012; 7:e32669. [PMID: 22412904 PMCID: PMC3296740 DOI: 10.1371/journal.pone.0032669] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2011] [Accepted: 02/02/2012] [Indexed: 01/08/2023] Open
Abstract
Background Keratins 8 and 18 (K8/K18) are intermediate filament proteins that protect the liver from various forms of injury. Exonic K8/K18 variants associate with adverse outcome in acute liver failure and with liver fibrosis progression in patients with chronic hepatitis C infection or primary biliary cirrhosis. Given the association of K8/K18 variants with end-stage liver disease and progression in several chronic liver disorders, we studied the importance of keratin variants in patients with hemochromatosis. Methods The entire K8/K18 exonic regions were analyzed in 162 hemochromatosis patients carrying homozygous C282Y HFE (hemochromatosis gene) mutations. 234 liver-healthy subjects were used as controls. Exonic regions were PCR-amplified and analyzed using denaturing high-performance liquid chromatography and DNA sequencing. Previously-generated transgenic mice overexpressing K8 G62C were studied for their susceptibility to iron overload. Susceptibility to iron toxicity of primary hepatocytes that express K8 wild-type and G62C was also assessed. Results We identified amino-acid-altering keratin heterozygous variants in 10 of 162 hemochromatosis patients (6.2%) and non-coding heterozygous variants in 6 additional patients (3.7%). Two novel K8 variants (Q169E/R275W) were found. K8 R341H was the most common amino-acid altering variant (4 patients), and exclusively associated with an intronic KRT8 IVS7+10delC deletion. Intronic, but not amino-acid-altering variants associated with the development of liver fibrosis. In mice, or ex vivo, the K8 G62C variant did not affect iron-accumulation in response to iron-rich diet or the extent of iron-induced hepatocellular injury. Conclusion In patients with hemochromatosis, intronic but not exonic K8/K18 variants associate with liver fibrosis development.
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Affiliation(s)
- Pavel Strnad
- Department of Internal Medicine I, University Medical Center Ulm, Ulm, Germany.
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