Wallace Sebastian J, Tacke Frank, Schwabe Robert F, Henderson Neil C
Centre for Inflammation Research, The Queen's Medical Research Institute, Edinburgh BioQuarter, University of Edinburgh, Edinburgh, UK.
Department of Hepatology and Gastroenterology, Campus Virchow-Klinikum (CVK) and Campus Charité Mitte (CCM), Charité-Universitätsmedizin Berlin, 13353 Berlin, Germany.
JHEP Rep. 2022 Jun 15;4(8):100524. doi: 10.1016/j.jhepr.2022.100524. eCollection 2022 Aug.
Non-alcoholic fatty liver disease (NAFLD) is reaching epidemic proportions, with a global prevalence of 25% in the adult population. Non-alcoholic steatohepatitis (NASH), which can lead to cirrhosis, has become the leading indication for liver transplantation in both Europe and the USA. Liver fibrosis is the consequence of sustained, iterative liver injury, and the main determinant of outcomes in NASH. The liver possesses remarkable inherent plasticity, and liver fibrosis can regress when the injurious agent is removed, thus providing opportunities to alter long-term outcomes through therapeutic interventions. Although hepatocyte injury is a key driver of NASH, multiple other cell lineages within the hepatic fibrotic niche play major roles in the perpetuation of inflammation, mesenchymal cell activation, extracellular matrix accumulation as well as fibrosis resolution. The constituents of this cellular interactome, and how the various subpopulations within the fibrotic niche interact to drive fibrogenesis is an area of active research. Important cellular components of the fibrotic niche include endothelial cells, macrophages, passaging immune cell populations and myofibroblasts. In this review, we will describe how rapidly evolving technologies such as single-cell genomics, spatial transcriptomics and single-cell ligand-receptor analyses are transforming our understanding of the cellular interactome in NAFLD/NASH, and how this new, high-resolution information is being leveraged to develop rational new therapies for patients with NASH.
非酒精性脂肪性肝病(NAFLD)正呈流行趋势,在全球成年人群中的患病率为25%。非酒精性脂肪性肝炎(NASH)可导致肝硬化,已成为欧洲和美国肝移植的主要适应症。肝纤维化是持续性、反复性肝损伤的结果,也是NASH预后的主要决定因素。肝脏具有显著的内在可塑性,当去除损伤因素时,肝纤维化可以消退,从而为通过治疗干预改变长期预后提供了机会。虽然肝细胞损伤是NASH的关键驱动因素,但肝纤维化微环境中的多种其他细胞谱系在炎症持续、间充质细胞活化、细胞外基质积累以及纤维化消退中起主要作用。这种细胞相互作用组的组成成分,以及纤维化微环境中的各种亚群如何相互作用以驱动纤维化形成,是一个活跃的研究领域。纤维化微环境的重要细胞成分包括内皮细胞、巨噬细胞、循环免疫细胞群体和成肌纤维细胞。在这篇综述中,我们将描述诸如单细胞基因组学、空间转录组学和单细胞配体-受体分析等快速发展的技术如何改变我们对NAFLD/NASH中细胞相互作用组的理解,以及如何利用这些新的高分辨率信息为NASH患者开发合理的新疗法。