Indiana University-Purdue University Indianapolis (IUPUI) / Hepatic fibrosis is a cellular repair mechanism that is initiated upon prolonged damage to the liver, resulting in an accumulation of excess extracellular matrix. This eventually leads to the formation of scar tissue, which disrupts the hepatic architecture and causes liver dysfunction. Hepatic stellate cells (HSCs) play a major role in hepatic fibrosis. However, the molecular mechanisms remain incompletely understood. Yes-associated protein (YAP) and transcriptional coactivator with PDZ-binding motif (TAZ or WWTR1), key players of the Hippo pathway, have been implicated in the liver fibrosis, but the HSC-specific functions of YAP and TAZ are largely unclear. Here we have identified Sirtuin 6 (SIRT6), an NAD+ dependent deacetylase, as a key epigenetic regulator in the protection against hepatic fibrosis by suppressing the YAP/TAZ activity. SIRT6 has been previously implicated in the regulation of the canonical transforming growth factor β (TGFβ)-SMAD3 pathway. This study has revealed the significant contribution of the non-canonical pathways including the Hippo pathway to the development of hepatic fibrosis. HSC-specific Sirt6 deficient mice developed severe fibrosis when fed a high-fat-cholesterol-cholate diet compared to their wild-type counterparts. YAP became more active in the SIRT6-deficient HSCs. Expression of the YAP/TAZ downstream genes like CTGF, CYR61 and ANKRD1 were elevated in the SIRT6-deficient HSCs. Biochemical and mutagenic analyses have revealed that SIRT6 deacetylates YAP and TAZ at key lysine residues and reprograms the composition of the TEA domain transcription factor complex to suppress the YAP/TAZ function in the hepatic fibrogenesis.

Purpose of the Review Mitochondrial dysfunction has long been proposed to play a crucial role in the pathogenesis of a considerable number of disorders, such as neurodegeneration, cancer, cardiovascular, and metabolic disorders, including obesity-related insulin resistance and non-alcoholic fatty liver disease (NAFLD). Mitochondria are highly dynamic organelles that undergo functional and structural adaptations to meet the metabolic requirements of the cell. Alterations in nutrient availability or cellular energy needs can modify their formation through biogenesis and the opposite processes of fission and fusion, the fragmentation, and connection of mitochondrial network areas respectively. Herein, we review and discuss the current literature on the significance of mitochondrial adaptations in obesity and metabolic dysregulation, emphasizing on the role of hepatocyte mitochondrial flexibility in obesity and NAFLD. Recent Findings Accumulating evidence suggests the involvement of mitochondrial morphology and bioenergetics dysregulations to the emergence of NAFLD and its progress to non-alcoholic steatohepatitis (NASH). Summary Most relevant data suggests that changes in liver mitochondrial dynamics and bioenergetics hold a key role in the pathogenesis of NAFLD. During obesity and NAFLD, oxidative stress occurs due to the excessive production of ROS, leading to mitochondrial dysfunction. As a result, mitochondria become incompetent and uncoupled from respiratory chain activities, further promoting hepatic fat accumulation, while leading to liver inflammation, insulin resistance, and disease’s deterioration. Elucidation of the mechanisms leading to dysfunctional mitochondrial activity of the hepatocytes during NAFLD is of predominant importance for the development of novel therapeutic approaches towards the treatment of this metabolic disorder.

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Overweight has become a major health care problem in Western societies and is accompanied by an increasing incidence and prevalence of non-alcoholic fatty liver disease (NAFLD). The progression from NAFLD to non-alcoholic steatohepatitis (NASH) marks a crucial tipping point in the progression of severe and irreversible liver diseases. This study aims to gain further insight into the molecular processes leading to the evolution from steatosis to steatohepatitis. Steatosis was induced in cultures of primary human hepatocytes by continuous five-day exposure to free fatty acids (FFAs). The kinetics of lipid accumulation, lipotoxicity, and oxidative stress were measured. Additionally, ER stress was evaluated by analyzing the protein expression profiles of its key players: PERK, IRE1a, and ATF6a. Our data revealed that hepatocytes are capable of storing enormous amounts of lipids without showing signs of lipotoxicity. Prolonged lipid accumulation did not create an imbalance in hepatocyte redox homeostasis or a reduction in antioxidative capacity. However, we observed an FFA-dependent increase in ER stress, revealing thresholds for triggering the activation of pathways associated with lipid stress, inhibition of protein translation, and apoptosis. Our study clearly showed that even severe lipid accumulation can be attenuated by cellular defenses, but regenerative capacities may be reduced.

Nonalcoholic fatty liver disease (NAFLD) is among the leading causes of end-stage liver disease. The impaired hepatic lipid metabolism in NAFLD is exhibited by dysregulated PPARα and SREBP-1c signaling pathways, which are central transcription factors associated with lipid degradation and de novo lipogenesis. Despite the growing prevalence of this disease, current pharmacological treatment options are unsatisfactory. Genistein, a soy isoflavone, has beneficial effects on lipid metabolism and may be a candidate for NAFLD treatment. In an in vitro model of hepatic steatosis, primary human hepatocytes (PHHs) were incubated with free fatty acids (FFAs) and different doses of genistein. Lipid accumulation and the cytotoxic effects of FFAs and genistein treatment were evaluated by colorimetric and enzymatic assays. Changes in lipid homeostasis were examined by RT-qPCR and Western blot analyses. PPARα protein expression was induced in steatotic PHHs, accompanied by an increase in CPT1L and ACSL1 mRNA. Genistein treatment increased PPARα protein expression only in control PHHs, while CPTL1 and ACSL1 were unchanged and PPARα mRNA was reduced. In steatotic PHHs, genistein reversed the increase in activated SREBP-1c protein. The model realistically reflected the molecular changes in hepatic steatosis. Genistein suppressed the activation of SREBP-1c in steatotic hepatocytes, but the genistein-mediated effects on PPARα were abolished by high hepatic lipid levels.

Overweight has become a major health care problem in Western societies and is accompanied by an increasing incidence and prevalence of non-alcoholic fatty liver disease (NAFLD). The progression from NAFLD to non-alcoholic steatohepatitis (NASH) marks a crucial tipping point in the progression of severe and irreversible liver diseases. This study aims to gain further insight into the molecular processes leading to the evolution from steatosis to steatohepatitis. Steatosis was induced in cultures of primary human hepatocytes by continuous five-day exposure to free fatty acids (FFAs). The kinetics of lipid accumulation, lipotoxicity, and oxidative stress were measured. Additionally, ER stress was evaluated by analyzing the protein expression profiles of its key players: PERK, IRE1a, and ATF6a. Our data revealed that hepatocytes are capable of storing enormous amounts of lipids without showing signs of lipotoxicity. Prolonged lipid accumulation did not create an imbalance in hepatocyte redox homeostasis or a reduction in antioxidative capacity. However, we observed an FFA-dependent increase in ER stress, revealing thresholds for triggering the activation of pathways associated with lipid stress, inhibition of protein translation, and apoptosis. Our study clearly showed that even severe lipid accumulation can be attenuated by cellular defenses, but regenerative capacities may be reduced.

Le diabète et/ou l’obésité sont associés à la stéatose hépatique non-alcoolique (SHNA). Cette maladie du foie affecte environ un tiers de la population nord-américaine. Elle peut progresser vers un stade d’inflammation, de stress oxydatif et de fibrose appelé la stéatohépatite pouvant éventuellement entraîner le développement d’un cancer primitif du foie comme le carcinome hépatocellulaire (CHC). Cependant, les mécanismes reliant la diète, les maladies métaboliques et le développement du cancer sont complexes et peu connus. Le coactivateur transcriptionnel PGC-1α est un important régulateur du métabolisme énergétique de la cellule et la perte de ce dernier mène à un métabolisme nutritionnel inefficace, ainsi qu’à des défauts mitochondriaux importants. Fait intéressant, une réduction de PGC-1α est retrouvée chez les patients atteints de la maladie du foie gras non-alcoolique (SHNA) et du carcinome hépatocellulaire (HCC). Nous avons précédemment démontré qu’une réduction de PGC- 1α dans le foie murin en combinaison avec une diète obésogène peut provoquer l’apparition de la stéatohépatite. Cependant, le rôle causal de PGC-1α dans le cancer du foie associé à la diète demeure inconnu. Ensuite, un variant génétique de PGC-1α (SNP rs8192678) modifie un résidu glycine en sérine à la position 482 (PGC-1α G482S) chez l’humain et mène à une perte de stabilité protéique dans des cellules hépatiques humaines. Ce polymorphisme est associé au développement de maladies métaboliques, mais son impact sur le cancer demeure inconnu. Enfin, le gène de PGC-1α (PPARGC1A) est régulé par deux promoteurs (proximal et alternatif) donnant naissance à différents isoformes (PGC-1α1-4) de fonctions inconnues. L’action indépendante de ces variants pourrait fournir des indices quant au paradoxe entourant les recherches sur PGC-1α. Nous posons l’hypothèse principale que la perte d’expression de PGC-1α dans le foie favorise le développement du cancer hépatique en réponse à une diète riche en gras/fructose et à l’agent carcinogène diéthylnitrosamine. Dans cette thèse, nous montrons que la perte de PGC-1α favorise le développement du cancer du foie dans un modèle murin combinant une diète obésogène et un carcinogène hépatique. En effet, PGC-1α est nécessaire au maintien de l’expression du marqueur épithélial E-cadhérine et à la réponse cellulaire (apoptose, yH2AX) face aux dommages hépatiques. Nous montrons également que le variant G481 stabilise PGC-1α au niveau protéique et a un effet protecteur contre le cancer du foie chez la souris. Enfin, à l’aide d’expériences in vivo et in vitro nous montrons que la forme canonique PGC-1α1 et le variant PGC-1α4 exercent des rôles distincts sur la mort des cellules hépatiques en réponse à l’inflammation. En conclusion, cette thèse apporte de nouvelles connaissances sur les fonctions de PGC-1α au sein des complications hépatiques associées aux maladies métaboliques et inflammatoires. / Diabetes and obesity are associated to nonalcoholic fatty liver disease (NAFLD). This pathology affects approximately 30% of the population in North America. It ranges from simple steatosis to a more severe necro-inflammatory form called nonalcoholic steatohepatitis (NASH) that can ultimately lead to cirrhosis and primary liver cancer, such as hepatocellular carcinoma (HCC). However, the relationship between diet, metabolic disorders, and cancer development is poorly understood. PGC-1α is a transcriptional coactivator that regulates cellular energy metabolism. Loss of PGC-1α can lead to inefficient nutrient metabolism and severe mitochondrial defects. Interestingly, patients with NAFLD/NASH and HCC exhibit reduced levels of hepatic PGC-1α. We have previously shown that low hepatic PGC-1α combined with an obesogenic diet leads to hallmarks of NASH in mice. However, whether low hepatic PGC-1α reflects a cause or a consequence of liver cancer remains to be determined. Furthermore, a single nucleotide polymorphism within the PPARGC1A coding sequence (SNP rs8192678) leads to a switch between glycine to serine residue at position 482 (PGC-1α G482S) in humans and is associated with reduced protein stability in human liver cells. This SNP is associated with metabolic disorders, but its impact on liver cancer remains un- known. Lastly, the PGC-1α gene (PPARGC1A) is regulated by two promoters (proximal and alternative) that give rise to different isoforms (PGC-1α1-4) of unknown functions. Independent actions of these isoforms could provide a plausible explanation for the paradox observed in previous studies covering the role of PGC-1α. We proposed the general hypothesis that loss of hepatic PGC-1α promotes diet-associated liver cancer development in mice through increased susceptibility to hepatotoxicity. In this thesis, we show that loss of hepatic PGC-1α promotes diet-associated liver cancer in mice. Indeed, PGC-1α is essential to maintain E-cadherin expression and liver cell response (apoptosis, yH2AX) to damage. We also show that G481 variant stabilizes hepatic PGC-1α protein and protects against liver cancer development in mice. Finally, using in vivo and in vitro experiments we show that canonical PGC-1α1 and the PGC-1α4 variant differentially regulate liver cell apoptosis in response to inflammatory signaling. In conclusion, this thesis sheds new light on the role of PGC-1α in liver complications associated with metabolic disorders and inflammation.