Department of Medicine, Robert Wood Johnson Medical School, and.
Rutgers Center for Lipid Research, New Jersey Institute for Food, Nutrition, and Health, Rutgers University, New Brunswick, New Jersey, USA.
J Clin Invest. 2022 May 16;132(10). doi: 10.1172/JCI145889.
Nonalcoholic fatty liver disease (NAFLD), the most common liver disease, has become a silent worldwide pandemic. The incidence of NAFLD correlates with the rise in obesity, type 2 diabetes, and metabolic syndrome. A hallmark featureof NAFLD is excessive hepatic fat accumulation or steatosis, due to dysregulated hepatic fat metabolism, which can progress to nonalcoholic steatohepatitis (NASH), fibrosis, and cirrhosis. Currently, there are no approved pharmacotherapies to treat this disease. Here, we have found that activation of the kisspeptin 1 receptor (KISS1R) signaling pathway has therapeutic effects in NAFLD. Using high-fat diet-fed mice, we demonstrated that a deletion of hepatic Kiss1r exacerbated hepatic steatosis. In contrast, enhanced stimulation of KISS1R protected against steatosis in wild-type C57BL/6J mice and decreased fibrosis using a diet-induced mouse model of NASH. Mechanistically, we found that hepatic KISS1R signaling activates the master energy regulator, AMPK, to thereby decrease lipogenesis and progression to NASH. In patients with NAFLD and in high-fat diet-fed mice, hepatic KISS1/KISS1R expression and plasma kisspeptin levels were elevated, suggesting a compensatory mechanism to reduce triglyceride synthesis. These findings establish KISS1R as a therapeutic target to treat NASH.
非酒精性脂肪性肝病(NAFLD)是最常见的肝脏疾病,已成为一种无声的全球大流行。NAFLD 的发病率与肥胖、2 型糖尿病和代谢综合征的上升相关。NAFLD 的一个标志特征是由于肝脂肪代谢失调而导致肝内脂肪过度积聚或脂肪变性,这可能进展为非酒精性脂肪性肝炎(NASH)、纤维化和肝硬化。目前,尚无批准的药物疗法可用于治疗这种疾病。在这里,我们发现激活 kisspeptin 1 受体(KISS1R)信号通路对 NAFLD 具有治疗作用。使用高脂肪饮食喂养的小鼠,我们证明肝 Kiss1r 的缺失会加剧肝脂肪变性。相比之下,增强 KISS1R 的刺激可保护野生型 C57BL/6J 小鼠免受脂肪变性的影响,并可通过 NASH 的饮食诱导小鼠模型减少纤维化。从机制上讲,我们发现肝 KISS1R 信号激活了主要的能量调节剂 AMPK,从而减少脂肪生成和进展为 NASH。在 NAFLD 患者和高脂肪饮食喂养的小鼠中,肝 KISS1/KISS1R 的表达和血浆 kisspeptin 水平升高,表明存在一种代偿机制来减少甘油三酯的合成。这些发现确立了 KISS1R 作为治疗 NASH 的治疗靶点。