The Center for Basic Research and Innovation of Medicine and Pharmacy (MOE), School of Pharmacy, Naval Medical University/Second Military Medical University, Shanghai, China.
Department of Biliary Surgery, Eastern Hepatobiliary Surgery Hospital, Naval Medical University, Shanghai, China.
J Hepatol. 2024 Sep;81(3):389-403. doi: 10.1016/j.jhep.2024.04.009. Epub 2024 Apr 25.
BACKGROUND & AIMS: The precise pathomechanisms underlying the development of non-alcoholic steatohepatitis (NASH, also known as metabolic dysfunction-associated steatohepatitis [MASH]) remain incompletely understood. In this study, we investigated the potential role of EF-hand domain family member D2 (EFHD2), a novel molecule specific to immune cells, in the pathogenesis of NASH. METHODS: Hepatic EFHD2 expression was characterized in patients with NASH and two diet-induced NASH mouse models. Single-cell RNA sequencing (scRNA-seq) and double-immunohistochemistry were employed to explore EFHD2 expression patterns in NASH livers. The effects of global and myeloid-specific EFHD2 deletion on NASH and NASH-related hepatocellular carcinoma were assessed. Molecular mechanisms underlying EFHD2 function were investigated, while chemical and genetic investigations were performed to assess its potential as a therapeutic target. RESULTS: EFHD2 expression was significantly elevated in hepatic macrophages/monocytes in both patients with NASH and mice. Deletion of EFHD2, either globally or specifically in myeloid cells, improved hepatic steatosis, reduced immune cell infiltration, inhibited lipid peroxidation-induced ferroptosis, and attenuated fibrosis in NASH. Additionally, it hindered the development of NASH-related hepatocellular carcinoma. Specifically, deletion of myeloid EFHD2 prevented the replacement of TIM4 resident Kupffer cells by infiltrated monocytes and reversed the decreases in patrolling monocytes and CD4/CD8 T cell ratio in NASH. Mechanistically, our investigation revealed that EFHD2 in myeloid cells interacts with cytosolic YWHAZ (14-3-3ζ), facilitating the translocation of IFNγR2 (interferon-γ receptor-2) onto the plasma membrane. This interaction mediates interferon-γ signaling, which triggers immune and inflammatory responses in macrophages during NASH. Finally, a novel stapled α-helical peptide targeting EFHD2 was shown to be effective in protecting against NASH pathology in mice. CONCLUSION: Our study reveals a pivotal immunomodulatory and inflammatory role of EFHD2 in NASH, underscoring EFHD2 as a promising druggable target for NASH treatment. IMPACT AND IMPLICATIONS: Non-alcoholic steatohepatitis (NASH) represents an advanced stage of non-alcoholic fatty liver disease (NAFLD); however, not all patients with NAFLD progress to NASH. A key challenge is identifying the factors that trigger inflammation, which propels the transition from simple fatty liver to NASH. Our research pinpointed EFHD2 as a pivotal driver of NASH, orchestrating the over-activation of interferon-γ signaling within the liver during NASH progression. A stapled peptide designed to target EFHD2 exhibited therapeutic promise in NASH mice. These findings support the potential of EFHD2 as a therapeutic target in NASH.
背景与目的:非酒精性脂肪性肝炎(NASH,也称为代谢功能障碍相关脂肪性肝炎[MASH])的发病机制尚不完全清楚。在本研究中,我们研究了 EF 手结构域家族成员 D2(EFHD2)在 NASH 发病机制中的潜在作用,EFHD2 是一种免疫细胞特异性的新分子。
方法:研究人员在 NASH 患者和两种饮食诱导的 NASH 小鼠模型中对肝脏 EFHD2 表达进行了特征描述。采用单细胞 RNA 测序(scRNA-seq)和双重免疫组织化学方法,探讨了 EFHD2 在 NASH 肝脏中的表达模式。评估了全身性和髓样细胞特异性 EFHD2 缺失对 NASH 和 NASH 相关肝细胞癌的影响。研究了 EFHD2 功能的分子机制,并进行了化学和遗传研究,以评估其作为治疗靶点的潜力。
结果:EFHD2 在 NASH 患者和小鼠的肝巨噬细胞/单核细胞中表达显著上调。EFHD2 全身性或髓样细胞特异性缺失可改善肝脂肪变性,减少免疫细胞浸润,抑制脂质过氧化诱导的铁死亡,并减轻 NASH 纤维化。此外,它还阻碍了 NASH 相关肝细胞癌的发展。具体而言,髓样细胞 EFHD2 的缺失可防止浸润的单核细胞取代 TIM4 固有 Kupffer 细胞,并逆转 NASH 中巡逻单核细胞和 CD4/CD8 T 细胞比例的降低。在机制上,我们的研究表明,髓样细胞中的 EFHD2 与细胞质 YWHAZ(14-3-3ζ)相互作用,促进干扰素-γ受体-2(IFNγR2)易位到质膜上。这种相互作用介导了干扰素-γ信号转导,在 NASH 期间触发巨噬细胞的免疫和炎症反应。最后,一种针对 EFHD2 的新型订书肽被证明可有效预防 NASH 病理改变。
结论:本研究揭示了 EFHD2 在 NASH 中的关键免疫调节和炎症作用,强调 EFHD2 是 NASH 治疗的一个有希望的药物靶点。
影响和意义:非酒精性脂肪性肝炎(NASH)是一种非酒精性脂肪性肝病(NAFLD)的晚期阶段;然而,并非所有的 NAFLD 患者都会进展为 NASH。一个关键的挑战是确定触发炎症的因素,炎症推动了从单纯脂肪肝向 NASH 的转变。我们的研究将 EFHD2 确定为 NASH 的关键驱动因素,在 NASH 进展过程中,EFHD2 协调了肝内干扰素-γ信号的过度激活。一种针对 EFHD2 的订书肽在 NASH 小鼠中表现出治疗潜力。这些发现支持 EFHD2 作为 NASH 治疗靶点的潜力。
J Hepatol. 2017-3-16
Cell Mol Immunol. 2025-6-10
Signal Transduct Target Ther. 2024-10-14