Lin Sihan, Dong Li, De Nardo William, Leeming Michael G, Cheng Zhili, Williamson Nicholas A, Watt Matthew J, Montgomery Magdalene K
Department of Anatomy and Physiology, The University of Melbourne, Melbourne, Victoria, Australia.
Melbourne Mass Spectrometry and Proteomics Facility, Bio21 Molecular Science & Biotechnology Institute, The University of Melbourne, Melbourne, Victoria, Australia.
Am J Physiol Endocrinol Metab. 2025 Mar 1;328(3):E377-E394. doi: 10.1152/ajpendo.00359.2024. Epub 2025 Feb 10.
The prevalence of metabolic dysfunction-associated steatohepatitis (MASH) is increasing at an alarming rate. To date, only one therapy has been provisionally approved for the treatment of MASH and liver fibrosis, and novel strategies are urgently needed. In addition, the frequent coexistence of MASH and type 2 diabetes has further intensified interest in devising comprehensive therapies to simultaneously tackle both diseases. We have recently shown that increasing hepatic and/or circulating levels of hexosaminidase A (HEXA), a lysosomal enzyme that remodels GM2 to GM3 gangliosides within lipid rafts, offers therapeutic benefits for metabolic dysfunction-associated steatotic liver disease (MASLD) and type 2 diabetes. Taking advantage of the MUP-uPA mouse model of MASH, including both wild-type (WT) mice with mild MASH and MUP-uPA mice with severe MASH and fibrosis, we show that biweekly treatment with a long-lasting HEXA-FC analog improves features of MASLD, including hepatic steatosis and hepatocyte ballooning, in mice with mild MASH, as well as glycemic control across both mouse models. Mechanistically, HEXA-FC enhances hepatic fatty acid oxidation and peripheral glucose disposal while not impacting endogenous glucose production. Together, these outcomes suggest that while HEXA-FC treatment may offer therapeutic benefits in mild MASH and insulin resistance, it is ineffective against severe MASH and liver fibrosis. The prevalence of metabolic dysfunction-associated steatohepatitis (MASH) and type 2 diabetes is increasing. Here, we show that chronic FC-HEXA recombinant protein treatment reduces hepatic lipid accumulation and improves blood glucose control in mice with mild MASH and insulin resistance.
代谢功能障碍相关脂肪性肝炎(MASH)的患病率正以惊人的速度上升。迄今为止,仅有一种疗法被临时批准用于治疗MASH和肝纤维化,因此迫切需要新的治疗策略。此外,MASH与2型糖尿病的频繁共存,进一步激发了人们对设计综合疗法以同时治疗这两种疾病的兴趣。我们最近发现,提高溶酶体酶己糖胺酶A(HEXA)在肝脏和/或循环系统中的水平具有治疗益处,该酶可将脂筏中的GM2神经节苷脂重塑为GM3神经节苷脂,对代谢功能障碍相关脂肪性肝病(MASLD)和2型糖尿病有效。利用MASH的MUP-uPA小鼠模型,包括患有轻度MASH的野生型(WT)小鼠和患有严重MASH及肝纤维化的MUP-uPA小鼠,我们发现,每两周用长效HEXA-FC类似物治疗一次,可改善轻度MASH小鼠的MASLD特征,包括肝脂肪变性和肝细胞气球样变,以及两种小鼠模型的血糖控制。从机制上讲,HEXA-FC可增强肝脏脂肪酸氧化和外周葡萄糖代谢,同时不影响内源性葡萄糖生成。综上所述,这些结果表明,虽然HEXA-FC治疗可能对轻度MASH和胰岛素抵抗具有治疗益处,但对严重MASH和肝纤维化无效。代谢功能障碍相关脂肪性肝炎(MASH)和2型糖尿病的患病率正在上升。在此,我们表明,慢性FC-HEXA重组蛋白治疗可减少轻度MASH和胰岛素抵抗小鼠的肝脏脂质积累,并改善血糖控制。