Department of Gastroenterology, The University of Tokyo, Tokyo, Japan.
Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
J Clin Invest. 2022 Jun 1;132(11). doi: 10.1172/JCI151895.
Enhanced de novo lipogenesis mediated by sterol regulatory element-binding proteins (SREBPs) is thought to be involved in nonalcoholic steatohepatitis (NASH) pathogenesis. In this study, we assessed the impact of SREBP inhibition on NASH and liver cancer development in murine models. Unexpectedly, SREBP inhibition via deletion of the SREBP cleavage-activating protein (SCAP) in the liver exacerbated liver injury, fibrosis, and carcinogenesis despite markedly reduced hepatic steatosis. These phenotypes were ameliorated by restoring SREBP function. Transcriptome and lipidome analyses revealed that SCAP/SREBP pathway inhibition altered the fatty acid (FA) composition of phosphatidylcholines due to both impaired FA synthesis and disorganized FA incorporation into phosphatidylcholine via lysophosphatidylcholine acyltransferase 3 (LPCAT3) downregulation, which led to endoplasmic reticulum (ER) stress and hepatocyte injury. Supplementation with phosphatidylcholines significantly improved liver injury and ER stress induced by SCAP deletion. The activity of the SCAP/SREBP/LPCAT3 axis was found to be inversely associated with liver fibrosis severity in human NASH. SREBP inhibition also cooperated with impaired autophagy to trigger liver injury. Thus, excessively strong and broad lipogenesis inhibition was counterproductive for NASH therapy; this will have important clinical implications in NASH treatment.
固醇调节元件结合蛋白 (SREBP) 介导的从头脂肪生成增强被认为与非酒精性脂肪性肝炎 (NASH) 的发病机制有关。在这项研究中,我们评估了 SREBP 抑制对 NASH 和肝癌发展的影响在小鼠模型中。出乎意料的是,尽管肝脂肪变性明显减少,但通过删除肝脏中的 SREBP 切割激活蛋白 (SCAP) 抑制 SREBP 会加剧肝损伤、纤维化和癌变。这些表型通过恢复 SREBP 功能得到改善。转录组和脂质组分析表明,SCAP/SREBP 通路抑制由于脂肪酸 (FA) 合成受损和通过下调溶血磷脂酰胆碱酰基转移酶 3 (LPCAT3) 使 FA 掺入磷脂酰胆碱紊乱,改变了磷脂酰胆碱的 FA 组成,导致内质网 (ER) 应激和肝细胞损伤。补充磷脂酰胆碱可显著改善由 SCAP 缺失引起的肝损伤和 ER 应激。发现 SCAP/SREBP/LPCAT3 轴的活性与人类 NASH 中肝纤维化严重程度呈负相关。SREBP 抑制还与受损的自噬协同作用引发肝损伤。因此,过度强烈和广泛的脂肪生成抑制对 NASH 治疗不利;这将对 NASH 治疗具有重要的临床意义。