Division of Gastroenterology, Hepatology, and NutritionCincinnati Children's Hospital Medical CenterCincinnatiOhioUSA.
Department of Biochemistry and BiophysicsProgram in Developmental and Stem Cell BiologyLiver Center and Diabetes CenterUniversity of California, San FranciscoSan FranciscoCaliforniaUSA.
Hepatol Commun. 2022 Nov;6(11):3083-3097. doi: 10.1002/hep4.2038. Epub 2022 Aug 26.
Hepatic cysts are fluid-filled lesions in the liver that are estimated to occur in 5% of the population. They may cause hepatomegaly and abdominal pain. Progression to secondary fibrosis, cirrhosis, or cholangiocarcinoma can lead to morbidity and mortality. Previous studies of patients and rodent models have associated hepatic cyst formation with increased proliferation and fluid secretion in cholangiocytes, which are partially due to impaired primary cilia. Congenital hepatic cysts are thought to originate from faulty bile duct development, but the underlying mechanisms are not fully understood. In a forward genetic screen, we identified a zebrafish mutant that developed hepatic cysts during larval stages. The cyst formation was not due to changes in biliary cell proliferation, bile secretion, or impairment of primary cilia. Instead, time-lapse live imaging data showed that the mutant biliary cells failed to form interconnecting bile ducts because of defects in motility and protrusive activity. Accordingly, immunostaining revealed a disorganized actin and microtubule cytoskeleton in the mutant biliary cells. By whole-genome sequencing, we determined that the cystic phenotype in the mutant was caused by a missense mutation in the furinb gene, which encodes a proprotein convertase. The mutation altered Furinb localization and caused endoplasmic reticulum (ER) stress. The cystic phenotype could be suppressed by treatment with the ER stress inhibitor 4-phenylbutyric acid and exacerbated by treatment with the ER stress inducer tunicamycin. The mutant liver also exhibited increased mammalian target of rapamycin (mTOR) signaling. Treatment with mTOR inhibitors halted cyst formation at least partially through reducing ER stress. Conclusion: Our study has established a vertebrate model for studying hepatic cystogenesis and illustrated the contribution of ER stress in the disease pathogenesis.
肝囊肿是肝脏中充满液体的病变,据估计其在人群中的发生率为 5%。它们可能导致肝肿大和腹痛。进展为继发性纤维化、肝硬化或胆管癌可导致发病率和死亡率。先前对患者和啮齿动物模型的研究表明,肝囊肿的形成与胆管细胞增殖和液体分泌增加有关,这部分是由于初级纤毛受损。先天性肝囊肿被认为起源于胆管发育不良,但潜在机制尚不完全清楚。在正向遗传筛选中,我们鉴定出一种在幼虫期形成肝囊肿的斑马鱼突变体。囊肿的形成不是由于胆管细胞增殖、胆汁分泌或初级纤毛受损的变化引起的。相反,延时实时成像数据显示,突变体胆管细胞由于运动和突起活性缺陷而未能形成相互连接的胆管。因此,免疫染色显示突变体胆管细胞中的肌动蛋白和微管细胞骨架排列紊乱。通过全基因组测序,我们确定突变体中的囊性表型是由于 furinb 基因的错义突变引起的,该基因编码一种蛋白原转化酶。该突变改变了 Furinb 的定位并导致内质网(ER)应激。用 ER 应激抑制剂 4-苯丁酸处理可以抑制囊性表型,用 ER 应激诱导剂衣霉素处理则会加剧囊性表型。突变体肝脏还表现出哺乳动物雷帕霉素靶蛋白(mTOR)信号的增加。用 mTOR 抑制剂治疗至少部分通过减少 ER 应激来阻止囊肿形成。结论:我们的研究建立了一个研究肝囊肿发生的脊椎动物模型,并说明了 ER 应激在疾病发病机制中的作用。