1
|
De Munck TJI, Boesch M, Verhaegh P, Masclee AAM, Jonkers D, van Pelt JF, du Plessis J, Korf H, Nevens F, Koek GH, Van der Merwe S, Verbeek J. Is there a role for neuregulin 4 in human nonalcoholic fatty liver disease? PLoS One 2021; 16:e0251822. [PMID: 33989346 PMCID: PMC8121306 DOI: 10.1371/journal.pone.0251822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 05/03/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Neuregulin 4 (Nrg4), a novel adipokine enriched in brown adipose tissue has been observed to negatively regulate de novo hepatic lipogenesis and limit nonalcoholic fatty liver disease (NAFLD) progression to nonalcoholic steatohepatitis (NASH) in rodents. However, the role of Nrg4 in human NAFLD remains unclear to date. We analysed Nrg4 plasma levels and its association with liver disease severity together with the transcriptional profile of the Nrg4 pathway in liver and visceral adipose tissue (VAT) of NAFLD patients. METHODS Plasma Nrg4 levels were measured in 65 NAFLD patients and 43 healthy controls (HC). Hepatic steatosis and fibrosis were diagnosed and quantified with chemical shift MRI and transient elastography respectively. Furthermore, blood lipid levels, HOMA-IR and systemic pro-inflammatory cytokines (TNF-α, IL-6 and IFN-γ) were analysed. Microarray analyses to assess differences in the Nrg4 and its receptor family ErbB pathway in liver and VAT from an independent patient group with biopsy proven NAFL (simple steatosis) (n = 4), NASH (n = 5) and normal liver (n = 6) were performed. RESULTS Plasma Nrg4 levels were not significantly different between NAFLD patients and HC (p = 0.622). Furthermore, plasma Nrg4 levels did not correlate with the hepatic fat fraction (r = -0.028, p = 0.829) and were not significantly different between NAFLD patients with or without hepatic fibrosis (p = 0.087). Finally, the expression profile of 82 genes related to the Nrg4-ErbB pathway in liver and VAT was not significantly different between NAFL, NASH or obese controls. CONCLUSION Our study does not support a role for Nrg4 in the pathophysiology of human NAFLD.
Collapse
Affiliation(s)
- Toon J. I. De Munck
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - Markus Boesch
- Laboratory of Hepatology, Department Chronic Diseases, Metabolism & Ageing (CHROMETA), KU Leuven, Leuven, Belgium
| | - Pauline Verhaegh
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - Ad A. M. Masclee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - Daisy Jonkers
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - Jos F. van Pelt
- Laboratory of Clinical Digestive Oncology, Department of Oncology, KU Leuven & University Hospitals Leuven and Leuven Cancer Institute (LKI), Leuven, Belgium
| | - Johannie du Plessis
- Laboratory of Hepatology, Department Chronic Diseases, Metabolism & Ageing (CHROMETA), KU Leuven, Leuven, Belgium
| | - Hannelie Korf
- Laboratory of Hepatology, Department Chronic Diseases, Metabolism & Ageing (CHROMETA), KU Leuven, Leuven, Belgium
| | - Frederik Nevens
- Laboratory of Hepatology, Department Chronic Diseases, Metabolism & Ageing (CHROMETA), KU Leuven, Leuven, Belgium
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
| | - Ger H. Koek
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
- School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University, Maastricht, The Netherlands
| | - Schalk Van der Merwe
- Laboratory of Hepatology, Department Chronic Diseases, Metabolism & Ageing (CHROMETA), KU Leuven, Leuven, Belgium
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
| | - Jef Verbeek
- Laboratory of Hepatology, Department Chronic Diseases, Metabolism & Ageing (CHROMETA), KU Leuven, Leuven, Belgium
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, Leuven, Belgium
- * E-mail:
| |
Collapse
|
2
|
Korf H, du Plessis J, van Pelt J, De Groote S, Cassiman D, Verbeke L, Ghesquière B, Fendt SM, Bird MJ, Talebi A, Van Haele M, Feio-Azevedo R, Meelberghs L, Roskams T, Mookerjee RP, Mehta G, Jalan R, Gustot T, Laleman W, Nevens F, van der Merwe SW. Inhibition of glutamine synthetase in monocytes from patients with acute-on-chronic liver failure resuscitates their antibacterial and inflammatory capacity. Gut 2019; 68:1872-1883. [PMID: 30580251 DOI: 10.1136/gutjnl-2018-316888] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 11/27/2018] [Accepted: 11/29/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Acute-on-chronic liver failure (ACLF) is associated with dysfunctional circulating monocytes whereby patients become highly susceptible to bacterial infections. Here, we identify the pathways underlying monocyte dysfunction in ACLF and we investigate whether metabolic rewiring reinstates their phagocytic and inflammatory capacity. DESIGN Following phenotypic characterisation, we performed RNA sequencing on CD14+CD16- monocytes from patients with ACLF and decompensated alcoholic cirrhosis. Additionally, an in vitro model mimicking ACLF patient-derived features was implemented to investigate the efficacy of metabolic regulators on monocyte function. RESULTS Monocytes from patients with ACLF featured elevated frequencies of interleukin (IL)-10-producing cells, reduced human leucocyte antigen DR isotype (HLA-DR) expression and impaired phagocytic and oxidative burst capacity. Transcriptional profiling of isolated CD14+CD16- monocytes in ACLF revealed upregulation of an array of immunosuppressive parameters and compromised antibacterial and antigen presentation machinery. In contrast, monocytes in decompensated cirrhosis showed intact capacity to respond to inflammatory triggers. Culturing healthy monocytes in ACLF plasma mimicked the immunosuppressive characteristics observed in patients, inducing a blunted phagocytic response and metabolic program associated with a tolerant state. Metabolic rewiring of the cells using a pharmacological inhibitor of glutamine synthetase, partially restored the phagocytic and inflammatory capacity of in vitro generated- as well as ACLF patient-derived monocytes. Highlighting its biological relevance, the glutamine synthetase/glutaminase ratio of ACLF patient-derived monocytes positively correlated with disease severity scores. CONCLUSION In ACLF, monocytes feature a distinct transcriptional profile, polarised towards an immunotolerant state and altered metabolism. We demonstrated that metabolic rewiring of ACLF monocytes partially revives their function, opening up new options for therapeutic targeting in these patients.
Collapse
Affiliation(s)
- Hannelie Korf
- Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, Leuven, Belgium
| | - Johannie du Plessis
- Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, Leuven, Belgium.,Department of Immunology, University of Pretoria, Pretoria, South Africa
| | - Jos van Pelt
- Department of Oncology, KU Leuven, and Leuven Cancer Institute (LKI), Leuven, Belgium
| | - Sofie De Groote
- Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, Leuven, Belgium
| | - David Cassiman
- Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, Leuven, Belgium.,Department of Gastroenterology and Hepatology, UZ Leuven, Leuven, Belgium
| | - Len Verbeke
- Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, Leuven, Belgium.,Department of Gastroenterology and Hepatology, UZ Leuven, Leuven, Belgium
| | - Bart Ghesquière
- Metabolomics Expertise Centrum, VIB-KU Leuven Center for Cancer Biology, KU Leuven, Leuven, Belgium
| | - Sarah-Maria Fendt
- Laboratory of Cellular Metabolism and Metabolic Regulation, VIB-KU Leuven Center for Cancer Biology, KU Leuven, Leuven, Belgium.,Department of Oncology, Laboratory of Cellular Metabolism and Metabolic Regulation, KU Leuven and Leuven Cancer Institute (LKI), Leuven, Belgium
| | - Matthew J Bird
- Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, Leuven, Belgium.,Metabolomics Expertise Centrum, VIB-KU Leuven Center for Cancer Biology, KU Leuven, Leuven, Belgium
| | - Ali Talebi
- Department of Oncology, Laboratory of Lipid Metabolism and Cancer, KU Leuven and Leuven Cancer Institute (LKI), KU Leuven, Leuven, Belgium
| | - Matthias Van Haele
- Department of Imaging and Pathology, Translational Cell and Tissue Research, KU Leuven and University Hospitals Leuven, Leuven, Belgium
| | - Rita Feio-Azevedo
- Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, Leuven, Belgium
| | - Lore Meelberghs
- Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, Leuven, Belgium
| | - Tania Roskams
- Department of Imaging and Pathology, Translational Cell and Tissue Research, KU Leuven and University Hospitals Leuven, Leuven, Belgium
| | - Rajeshwar P Mookerjee
- Liver Failure Group, Institute for Liver Disease Health, University College London, London, UK
| | - Gautam Mehta
- Liver Failure Group, Institute for Liver Disease Health, University College London, London, UK
| | - Rajiv Jalan
- Liver Failure Group, Institute for Liver Disease Health, University College London, London, UK
| | - Thierry Gustot
- Department of Gastroenterology and Hepato-Pancreatology, Hôpital Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Wim Laleman
- Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, Leuven, Belgium.,Department of Gastroenterology and Hepatology, UZ Leuven, Leuven, Belgium
| | - Frederik Nevens
- Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, Leuven, Belgium.,Department of Gastroenterology and Hepatology, UZ Leuven, Leuven, Belgium
| | - Schalk Willem van der Merwe
- Department of Chronic Diseases, Metabolism and Ageing (CHROMETA), KU Leuven, Leuven, Belgium.,Department of Gastroenterology and Hepatology, UZ Leuven, Leuven, Belgium
| |
Collapse
|
3
|
Meersseman P, Langouche L, du Plessis J, Korf H, Mekeirele M, Laleman W, Nevens F, Wilmer A, Van den Berghe G, van der Merwe SW. The intensive care unit course and outcome in acute-on-chronic liver failure are comparable to other populations. J Hepatol 2018; 69:803-809. [PMID: 29730473 DOI: 10.1016/j.jhep.2018.04.025] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 04/04/2018] [Accepted: 04/23/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND & AIMS Acute-on-chronic liver failure (ACLF) is characterized by acute decompensation of cirrhosis, development of organ failure and high short-term mortality. Whether the outcome in patients admitted to the intensive care unit (ICU) with ACLF differs from other ICU populations is unknown. We compared the clinical course and host response in ICU patients with or without ACLF, matched for baseline severity of illness scores and characteristics. METHODS From the large prospective EPaNIC randomized control trial database (n = 4,640), 133 patients were identified with cirrhosis of whom 71 fulfilled the Chronic Liver Failure Consortium criteria for ACLF. These patients were matched for type and severity of illness and demographics to 71 septic and 71 medical ICU patients from the same database without chronic liver disease. Clinical, biochemical and outcome parameters were compared in this cohort study of 213 patients. In a subset of 100 patients, day 1 serum cytokines were quantified. RESULTS The outcome of ACLF, when compared to septic or medical ICU patients, matched for baseline parameters of illness severity, was similar regarding length of ICU stay, development of new infections, organ failure and septic shock. ICU, hospital and 90-day mortality were similar between the groups. C-reactive protein and platelet levels were lower in patients with ACLF throughout the first week. Cytokines, including IL-10, IL-1β, IL-6, and IL-8, were similarly elevated in ACLF and septic ICU patients on day 1. However, TNF-α levels were higher in patients with ACLF. CONCLUSION Patients with ACLF admitted to the ICU showed comparable clinical and ICU outcomes as ICU patients without chronic liver disease, but with similar baseline severity of illness characteristics. This suggests that ICU admission criteria should not be different in ACLF populations. LAY SUMMARY Liver function may abruptly deteriorate in patients with chronic liver disease with cirrhosis, often resulting in these patients being admitted to an intensive care unit (ICU) with organ failure. Previous studies have indicated that this sudden deterioration, called acute-on-chronic liver failure is associated with very high mortality rates, which often resulted in deferred ICU care because of a perception of futility. Our study now shows that the ICU course and outcome are not different when patients with acute-on-chronic liver failure are compared to other ICU patients matched for severity of illness. This demonstrates that patients with acute-on-chronic liver failure deserve the same ICU care given to other ICU populations.
Collapse
Affiliation(s)
- Philippe Meersseman
- Department of Internal Medicine, University Hospitals Leuven [KU Leuven], Belgium.
| | - Lies Langouche
- Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, University of Leuven [KU Leuven], Belgium
| | | | - Hannelie Korf
- Laboratory of Hepatology, University of Leuven [KU Leuven], Belgium
| | - Michaël Mekeirele
- Department of Internal Medicine, University Hospitals Leuven [KU Leuven], Belgium
| | - Wim Laleman
- Laboratory of Hepatology, University of Leuven [KU Leuven], Belgium; Department of Gastroenterology and Hepatology, University Hospitals Leuven [KU Leuven], Belgium
| | - Frederik Nevens
- Laboratory of Hepatology, University of Leuven [KU Leuven], Belgium; Department of Gastroenterology and Hepatology, University Hospitals Leuven [KU Leuven], Belgium
| | - Alexander Wilmer
- Department of Internal Medicine, University Hospitals Leuven [KU Leuven], Belgium
| | - Greet Van den Berghe
- Clinical Division and Laboratory of Intensive Care Medicine, Department of Cellular and Molecular Medicine, University of Leuven [KU Leuven], Belgium
| | - Schalk W van der Merwe
- Laboratory of Hepatology, University of Leuven [KU Leuven], Belgium; Department of Gastroenterology and Hepatology, University Hospitals Leuven [KU Leuven], Belgium.
| |
Collapse
|
4
|
du Plessis J, Korf H, van Pelt J, Windmolders P, Vander Elst I, Verrijken A, Hubens G, Van Gaal L, Cassiman D, Nevens F, Francque S, van der Merwe S. Pro-Inflammatory Cytokines but Not Endotoxin-Related Parameters Associate with Disease Severity in Patients with NAFLD. PLoS One 2016; 11:e0166048. [PMID: 27992443 PMCID: PMC5167229 DOI: 10.1371/journal.pone.0166048] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 10/22/2016] [Indexed: 12/30/2022] Open
Abstract
Intestinal dysbiosis and elevated lipopolysaccharides (LPS) levels have been implicated in the development of obesity, insulin resistance and non-alcoholic steatohepatitis (NASH). In order to determine if LPS levels are elevated in patients with NASH compared to patients with non-alcoholic fatty liver (NAFL) and, if elevated LPS levels correlated with histological severity of non-alcoholic fatty liver disease (NAFLD) we compared LPS, markers of LPS bioactivity and pro-inflammatory cytokines/chemokines in patients undergoing bariatric surgery. At the time of surgery a liver biopsy was taken allowing the stratification into well-delineated subgroups including: No NAFL/NAFL; NASH; NASH with fibrosis and NASH cirrhotics, using the NAFLD Activity Score (NAS). Anthropometric data and plasma were collected for assessment of LPS, lipopolysaccharide binding protein (LBP), soluble CD14 (sCD14), intestinal-type fatty acid binding protein (iFABP), Toll-like receptors 2 and 4 (TLR2, 4) and a panel of cytokines/chemokines. Similar analysis was performed on plasma from a cohort of healthy controls. Our data indicate elevated levels of LPS, LBP, sCD14, iFABP and TLR2,4 in obese patients compared to healthy controls, however, these parameters remained unaltered within patients with limited liver disease (NAFL) compared to NASH/NASH with fibrosis subgroups. Hierarchic cluster analysis using endotoxin-related parameters failed to discriminate between lean controls, NAFLD. While similar cluster analysis implementing inflammation-related parameters clearly distinguished lean controls, NALFD subgroups and NASH cirrhotics. In addition, LPS levels was not associated with disease severity while TNFα, IL8, and CCL3 featured a clear correlation with transaminase levels and the histological severity of NALFD. In conclusion our data indicate a stronger correlation for circulating inflammatory- rather than endotoxin-related parameters in progression of NAFLD and highlights the need for additional larger studies in unravelling further mechanistic insights.
Collapse
Affiliation(s)
- Johannie du Plessis
- Laboratory of Hepatology, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium
| | - Hannelie Korf
- Laboratory of Hepatology, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium
- Translational Research Center for Gastrointestinal Disorders (TARGID), Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium
| | - Jos van Pelt
- Laboratory of Hepatology, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium
| | - Petra Windmolders
- Laboratory of Hepatology, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium
| | - Ingrid Vander Elst
- Laboratory of Hepatology, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium
| | - An Verrijken
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - Guy Hubens
- Department of Abdominal Surgery, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - Luc Van Gaal
- Department of Gastroenterology and Hepatology, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - David Cassiman
- Laboratory of Hepatology, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium
- Department of Internal Medicine, Division of Liver and biliopancreatic disorders, KU Leuven, Leuven, Belgium
| | - Frederik Nevens
- Laboratory of Hepatology, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium
- Department of Internal Medicine, Division of Liver and biliopancreatic disorders, KU Leuven, Leuven, Belgium
| | - Sven Francque
- Department of Gastroenterology and Hepatology, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium
| | - Schalk van der Merwe
- Laboratory of Hepatology, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium
- Department of Internal Medicine, Division of Liver and biliopancreatic disorders, KU Leuven, Leuven, Belgium
- * E-mail:
| |
Collapse
|
5
|
Cassol E, Rossouw T, Malfeld S, Mahasha P, Slavik T, Seebregts C, Bond R, du Plessis J, Janssen C, Roskams T, Nevens F, Alfano M, Poli G, van der Merwe SW. CD14(+) macrophages that accumulate in the colon of African AIDS patients express pro-inflammatory cytokines and are responsive to lipopolysaccharide. BMC Infect Dis 2015; 15:430. [PMID: 26475133 PMCID: PMC4609115 DOI: 10.1186/s12879-015-1176-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 10/05/2015] [Indexed: 01/05/2023] Open
Abstract
Background Intestinal macrophages are key regulators of inflammatory responses to the gut microbiome and play a central role in maintaining tissue homeostasis and epithelial integrity. However, little is known about the role of these cells in HIV infection, a disease fuelled by intestinal inflammation, a loss of epithelial barrier function and increased microbial translocation (MT). Methods Phenotypic and functional characterization of intestinal macrophages was performed for 23 African AIDS patients with chronic diarrhea and/or weight loss and 11 HIV-negative Africans with and without inflammatory bowel disease (IBD). AIDS patients were treated with cotrimoxazole for the prevention of opportunistic infections (OIs). Macrophage phenotype was assessed by flow cytometry and immuno-histochemistry (IHC); production of proinflammatory mediators by IHC and Qiagen PCR Arrays; in vitro secretion of cytokines by the Bio-Plex Suspension Array System. Statistical analyses were performed using Spearman’s correlation and Wilcoxon matched-pair tests. Results between groups were analyzed using the Kruskal-Wallis with Dunn’s post-test and the Mann–Whitney U tests. Results None of the study participants had evidence of enteric co-infections as assessed by stool analysis and histology. Compared to healthy HIV-negative controls, the colon of AIDS patients was highly inflamed with increased infiltration of inflammatory cells and increased mRNA expression of proinflammatory cytokine (tumour necrosis factor (TNF)-α, interleukin (IL)-1β, IFN-γ, and IL-18), chemokines (chemokine (C-C motif) ligand (CCL)2 and chemokine (C-X-C) motif ligand (CXCL)10) and transcription factors (TNF receptor-associated factor (TRAF)6 and T-box (TXB)21). IHC revealed significant co-localization of TNF-α and IL-1β with CD68+ cells. As in IBD, HIV was associated with a marked increase in macrophages expressing innate response receptors including CD14, the co-receptor for lipopolysaccharide (LPS). The frequency of CD14+ macrophages correlated positively with plasma LPS, a marker of MT. Total unfractionated mucosal mononuclear cells (MMC) isolated from the colon of AIDS patients, but not MMC depleted of CD14+ cells, secreted increased levels of proinflammatory cytokines ex vivo in response to LPS. Conclusions Intestinal macrophages, in the absence of overt OIs, play an important role in driving persistent inflammation in HIV patients with late-stage disease and diarrhea. These results suggest intensified treatment strategies that target inflammatory processes in intestinal macrophages may be highly beneficial in restoring the epithelial barrier and limiting MT in HIV-infected patients.
Collapse
Affiliation(s)
- Edana Cassol
- MRC Unit for Inflammation and Immunity, Department of Immunology and the Tshwane Academic Division of the National Health Laboratory Service, University of Pretoria, Pretoria, South Africa. .,Department of Health Sciences, Carleton University, 5433 Herzberg Laboratories, 1125 Colonel By Drive, Ottawa, Ontario, K1S 5B6, Canada.
| | - Theresa Rossouw
- MRC Unit for Inflammation and Immunity, Department of Immunology and the Tshwane Academic Division of the National Health Laboratory Service, University of Pretoria, Pretoria, South Africa. .,Department of Family Medicine, University of Pretoria, Pretoria, South Africa.
| | - Susan Malfeld
- MRC Unit for Inflammation and Immunity, Department of Immunology and the Tshwane Academic Division of the National Health Laboratory Service, University of Pretoria, Pretoria, South Africa.
| | - Phetole Mahasha
- MRC Unit for Inflammation and Immunity, Department of Immunology and the Tshwane Academic Division of the National Health Laboratory Service, University of Pretoria, Pretoria, South Africa.
| | - Tomas Slavik
- Department of Anatomical Pathology, University of Pretoria and Ampath Pathology Laboratories, Pretoria, South Africa.
| | - Chris Seebregts
- Jembi Health Systems NPC, Durban, South Africa. .,School of Mathematics, Statistics and Computer Science, University of KwaZulu-Natal, Durban, South Africa.
| | - Robert Bond
- Hepatology and GI-Research Laboratory, University of Pretoria, Pretoria, South Africa.
| | - Johannie du Plessis
- Hepatology and GI-Research Laboratory, University of Pretoria, Pretoria, South Africa.
| | - Carl Janssen
- Hepatology and GI-Research Laboratory, University of Pretoria, Pretoria, South Africa.
| | - Tania Roskams
- Translational Cell and Tissue Research, Department of Imaging and Pathology, University of Leuven, Leuven, Belgium.
| | - Frederik Nevens
- Department of Hepatology, University of Leuven, Leuven, Belgium.
| | - Massimo Alfano
- San Raffaele Scientific Institute, School of Medicine, Milan, Italy. .,Present Address: Division of Experimental Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.
| | - Guido Poli
- San Raffaele Scientific Institute, School of Medicine, Milan, Italy. .,Vita-Salute San Raffaele University, School of Medicine, Milan, Italy. .,Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - Schalk W van der Merwe
- MRC Unit for Inflammation and Immunity, Department of Immunology and the Tshwane Academic Division of the National Health Laboratory Service, University of Pretoria, Pretoria, South Africa. .,Department of Internal Medicine, Division of Liver and Biliopancreatic Disorders, University of Leuven, Leuven, Belgium.
| |
Collapse
|
6
|
du Plessis J, van Pelt J, Korf H, Mathieu C, van der Schueren B, Lannoo M, Oyen T, Topal B, Fetter G, Nayler S, van der Merwe T, Windmolders P, Van Gaal L, Verrijken A, Hubens G, Gericke M, Cassiman D, Francque S, Nevens F, van der Merwe S. Association of Adipose Tissue Inflammation With Histologic Severity of Nonalcoholic Fatty Liver Disease. Gastroenterology 2015; 149:635-48.e14. [PMID: 26028579 DOI: 10.1053/j.gastro.2015.05.044] [Citation(s) in RCA: 217] [Impact Index Per Article: 24.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 05/15/2015] [Accepted: 05/20/2015] [Indexed: 12/27/2022]
Abstract
BACKGROUND & AIMS The prevalence of nonalcoholic fatty liver disease (NAFLD) has increased with the obesity pandemic. We analyzed the transcriptional profiles of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT), and phenotypes and functional characteristics of adipocyte tissue macrophages (ATMs), in obese patients undergoing bariatric surgery. METHODS We collected anthropometric data; plasma samples; and SAT, VAT, and liver tissues from 113 obese patients undergoing bariatric surgery at academic hospitals in Europe (Antwerp and Leuven) and South Africa. Based on clinical and histologic features, patients were assigned to the following groups: obese, NAFLD, nonalcoholic steatohepatitis (NASH), or NASH with fibrosis. Microarray analyses were performed to identify genes expressed differentially among groups. We measured levels of cytokines and chemokines in plasma samples and levels of RNAs in adipose tissues by quantitative reverse-transcription polymerase chain reaction. ATMs were isolated from patients and 13 lean individuals undergoing cholecystectomy (controls), analyzed by flow cytometry, and cultured; immunophenotypes and levels of cytokines and chemokines in supernatants were determined. RESULTS We observed increased expression of genes that regulate inflammation in adipose tissues from patients with NAFLD and NASH; expression of these genes increased as disease progressed from NAFLD to NASH. We found 111 genes associated with inflammation that were expressed differentially between VAT and SAT. Serum levels of interleukin 8, chemokine (C-C motif) ligand 3, and tumor necrosis factor-α correlated with liver inflammation and NAFLD activity score. We developed 2 models that could be used to determine patients' liver histology based on gene expression in VAT and SAT. Flow cytometry showed increased proportions of CD11c+CD206+ and CCR2+ macrophages in VAT from patients with NASH, and supernatants of cultured macrophages had increased levels of cytokines and chemokines compared with controls. CONCLUSIONS VAT and SAT from patients with NAFLD and NASH have an increased expression of genes that regulate inflammation, and ATM produce increased levels of inflammatory cytokines, compared with adipose tissues from controls. We identified an expression profile of 5 genes in SAT that accurately predict liver histology in these patients. Transcript profiling: accession numbers: GSE58979 and GSE59045.
Collapse
Affiliation(s)
- Johannie du Plessis
- Laboratory of Hepatology, Faculty of Medicine, University of Leuven, Leuven, Belgium; Department of Immunology, Hepatology and GI Research Laboratory, University of Pretoria, Pretoria, South Africa
| | - Jos van Pelt
- Laboratory of Hepatology, Faculty of Medicine, University of Leuven, Leuven, Belgium
| | - Hannelie Korf
- Laboratory of Clinical and Experimental Endocrinology, University of Leuven, Leuven, Belgium
| | - Chantal Mathieu
- Laboratory of Clinical and Experimental Endocrinology, University of Leuven, Leuven, Belgium
| | - Bart van der Schueren
- Laboratory of Clinical and Experimental Endocrinology, University of Leuven, Leuven, Belgium
| | - Matthias Lannoo
- Department of Abdominal Surgery, University of Leuven, Leuven, Belgium
| | - Tom Oyen
- Department of Abdominal Surgery, University of Leuven, Leuven, Belgium
| | - Baki Topal
- Department of Abdominal Surgery, University of Leuven, Leuven, Belgium
| | - Gary Fetter
- Waterfall City Centre of Excellence, Waterfall City Hospital, Johannesburg, South Africa
| | - Simon Nayler
- Histopathology, The Wits University Donald Gordon Medical Centre, Johannesburg, South Africa
| | - Tessa van der Merwe
- Waterfall City Centre of Excellence, Waterfall City Hospital, Johannesburg, South Africa; Department of Endocrinology, University of Pretoria, Pretoria, South Africa
| | - Petra Windmolders
- Laboratory of Hepatology, Faculty of Medicine, University of Leuven, Leuven, Belgium
| | - Luc Van Gaal
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, University of Antwerp, Edegem, Belgium
| | - An Verrijken
- Department of Endocrinology, Diabetology and Metabolism, Antwerp University Hospital, University of Antwerp, Edegem, Belgium
| | - Guy Hubens
- Department of Abdominal Surgery, Antwerp University Hospital, University of Antwerp, Edegem, Belgium
| | | | - David Cassiman
- Laboratory of Hepatology, Faculty of Medicine, University of Leuven, Leuven, Belgium; Department of Internal Medicine, Division of Liver, Gallbladder and Pancreaticobiliary Disorders, University Hospital Gasthuisberg, Leuven, Belgium
| | - Sven Francque
- Department of Gastroenterology and Hepatology, Antwerp University Hospital, University of Antwerp, Edegem, Belgium
| | - Frederik Nevens
- Laboratory of Hepatology, Faculty of Medicine, University of Leuven, Leuven, Belgium; Department of Internal Medicine, Division of Liver, Gallbladder and Pancreaticobiliary Disorders, University Hospital Gasthuisberg, Leuven, Belgium
| | - Schalk van der Merwe
- Laboratory of Hepatology, Faculty of Medicine, University of Leuven, Leuven, Belgium; Department of Internal Medicine, Division of Liver, Gallbladder and Pancreaticobiliary Disorders, University Hospital Gasthuisberg, Leuven, Belgium.
| |
Collapse
|
7
|
du Plessis J, van der Merwe SW. Reply to: "Uncovering the molecular events associated with increased intestinal permeability in liver cirrhosis: The pivotal role of enterocyte tight junctions and future perspectives". J Hepatol 2013; 59:1146-7. [PMID: 23928405 DOI: 10.1016/j.jhep.2013.07.031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 07/29/2013] [Indexed: 12/24/2022]
|