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Benedé-Ubieto R, Estévez-Vázquez O, Guo F, Chen C, Singh Y, Nakaya HI, Gómez Del Moral M, Lamas-Paz A, Morán L, López-Alcántara N, Reissing J, Bruns T, Avila MA, Santamaría E, Mazariegos MS, Woitok MM, Haas U, Zheng K, Juárez I, Martín-Villa JM, Asensio I, Vaquero J, Peligros MI, Argemi J, Bataller R, Ampuero J, Romero Gómez M, Trautwein C, Liedtke C, Bañares R, Cubero FJ, Nevzorova YA. An Experimental DUAL Model of Advanced Liver Damage. Hepatol Commun 2021; 5:1051-1068. [PMID: 34141989 PMCID: PMC8183170 DOI: 10.1002/hep4.1698] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/22/2021] [Accepted: 02/07/2021] [Indexed: 12/11/2022] Open
Abstract
Individuals exhibiting an intermediate alcohol drinking pattern in conjunction with signs of metabolic risk present clinical features of both alcohol-associated and metabolic-associated fatty liver diseases. However, such combination remains an unexplored area of great interest, given the increasing number of patients affected. In the present study, we aimed to develop a preclinical DUAL (alcohol-associated liver disease plus metabolic-associated fatty liver disease) model in mice. C57BL/6 mice received 10% vol/vol alcohol in sweetened drinking water in combination with a Western diet for 10, 23, and 52 weeks (DUAL model). Animals fed with DUAL diet elicited a significant increase in body mass index accompanied by a pronounced hypertrophy of adipocytes, hypercholesterolemia, and hyperglycemia. Significant liver damage was characterized by elevated plasma alanine aminotransferase and lactate dehydrogenase levels, extensive hepatomegaly, hepatocyte enlargement, ballooning, steatosis, hepatic cell death, and compensatory proliferation. Notably, DUAL animals developed lobular inflammation and advanced hepatic fibrosis. Sequentially, bridging cirrhotic changes were frequently observed after 12 months. Bulk RNA-sequencing analysis indicated that dysregulated molecular pathways in DUAL mice were similar to those of patients with steatohepatitis. Conclusion: Our DUAL model is characterized by obesity, glucose intolerance, liver damage, prominent steatohepatitis and fibrosis, as well as inflammation and fibrosis in white adipose tissue. Altogether, the DUAL model mimics all histological, metabolic, and transcriptomic gene signatures of human advanced steatohepatitis, and therefore serves as a preclinical tool for the development of therapeutic targets.
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Affiliation(s)
- Raquel Benedé-Ubieto
- Department of Physiology, Genetics and MicrobiologyFaculty of BiologyComplutense University MadridMadridSpain.,Department of Immunology, Ophthalmology and ENTComplutense University School of MedicineMadridSpain
| | - Olga Estévez-Vázquez
- Department of Physiology, Genetics and MicrobiologyFaculty of BiologyComplutense University MadridMadridSpain.,Department of Immunology, Ophthalmology and ENTComplutense University School of MedicineMadridSpain
| | - Feifei Guo
- Department of Immunology, Ophthalmology and ENTComplutense University School of MedicineMadridSpain
| | - Chaobo Chen
- Department of Immunology, Ophthalmology and ENTComplutense University School of MedicineMadridSpain
| | - Youvika Singh
- Department of Clinical and Toxicological AnalysesSchool of Pharmaceutical SciencesUniversity of São PauloSão PauloBrazil
| | - Helder I Nakaya
- Department of Clinical and Toxicological AnalysesSchool of Pharmaceutical SciencesUniversity of São PauloSão PauloBrazil.,Scientific Platform PasteurUniversity of São PauloSão PauloBrazil
| | | | - Arantza Lamas-Paz
- Department of Immunology, Ophthalmology and ENTComplutense University School of MedicineMadridSpain
| | - Laura Morán
- Department of Immunology, Ophthalmology and ENTComplutense University School of MedicineMadridSpain
| | - Nuria López-Alcántara
- Department of Immunology, Ophthalmology and ENTComplutense University School of MedicineMadridSpain.,Institute for Endocrinology and DiabetesCenter of Brain Behavior & MetabolismUniversity of LübeckLübeckGermany
| | - Johanna Reissing
- Department of Internal Medicine IIIUniversity Hospital RWTHAachenGermany
| | - Tony Bruns
- Department of Internal Medicine IIIUniversity Hospital RWTHAachenGermany
| | - Matías A Avila
- Hepatology ProgramCIMAUniversity of NavarraPamplonaSpain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y DigestivasInstituto de Salud Carlos IIIMadridSpain.,Instituto de Investigaciones Sanitarias de NavarraPamplonaSpain
| | - Eva Santamaría
- Hepatology ProgramCIMAUniversity of NavarraPamplonaSpain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y DigestivasInstituto de Salud Carlos IIIMadridSpain
| | - Marina S Mazariegos
- Department of Immunology, Ophthalmology and ENTComplutense University School of MedicineMadridSpain
| | | | - Ute Haas
- Department of Internal Medicine IIIUniversity Hospital RWTHAachenGermany
| | - Kang Zheng
- Department of Immunology, Ophthalmology and ENTComplutense University School of MedicineMadridSpain.,12 de Octubre Health Research InstituteMadridSpain.,Department of AnesthesiologyZhongda HospitalSchool of MedicineSoutheast UniversityNanjingChina
| | - Ignacio Juárez
- Department of Immunology, Ophthalmology and ENTComplutense University School of MedicineMadridSpain
| | - José Manuel Martín-Villa
- Department of Immunology, Ophthalmology and ENTComplutense University School of MedicineMadridSpain.,Instituto de Investigación Sanitaria Gregorio MarañónMadridSpain
| | - Iris Asensio
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y DigestivasInstituto de Salud Carlos IIIMadridSpain.,Instituto de Investigación Sanitaria Gregorio MarañónMadridSpain.,Servicio de Aparato DigestivoHospital General Universitario Gregorio MarañónMadridSpain
| | - Javier Vaquero
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y DigestivasInstituto de Salud Carlos IIIMadridSpain.,Instituto de Investigación Sanitaria Gregorio MarañónMadridSpain.,Servicio de Aparato DigestivoHospital General Universitario Gregorio MarañónMadridSpain
| | - Maria Isabel Peligros
- Servicio de Anatomía PatológicaHospital General Universitario Gregorio MarañónMadridSpain
| | - Josepmaria Argemi
- Division of Gastroenterology, Hepatology and NutritionCenter for Liver DiseasesUniversity of PittsburghPittsburghPAUSA.,Liver UnitClinica Universidad de Navarra, University of NavarraPamplonaSpain.,Hepatology ProgramCentro de Investigación Médica AplicadaUniversidad de NavarraPamplonaSpain
| | - Ramón Bataller
- Division of Gastroenterology, Hepatology and NutritionCenter for Liver DiseasesUniversity of PittsburghPittsburghPAUSA.,Pittsburgh Liver Research CenterUniversity of PittsburghPittsburghPAUSA
| | - Javier Ampuero
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y DigestivasInstituto de Salud Carlos IIIMadridSpain.,Biomedical Research Networking Center in Hepatic and Digestive DiseasesInstituto de Biomedicina de SevillaHospital Universitario Virgen del Rocío de SevillaUniversity of SevillaSevillaSpain
| | - Manuel Romero Gómez
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y DigestivasInstituto de Salud Carlos IIIMadridSpain.,Biomedical Research Networking Center in Hepatic and Digestive DiseasesInstituto de Biomedicina de SevillaHospital Universitario Virgen del Rocío de SevillaUniversity of SevillaSevillaSpain
| | | | - Christian Liedtke
- Department of Internal Medicine IIIUniversity Hospital RWTHAachenGermany
| | - Rafael Bañares
- Department of Immunology, Ophthalmology and ENTComplutense University School of MedicineMadridSpain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y DigestivasInstituto de Salud Carlos IIIMadridSpain.,Instituto de Investigación Sanitaria Gregorio MarañónMadridSpain.,Servicio de Aparato DigestivoHospital General Universitario Gregorio MarañónMadridSpain
| | - Francisco Javier Cubero
- Department of Immunology, Ophthalmology and ENTComplutense University School of MedicineMadridSpain.,12 de Octubre Health Research InstituteMadridSpain
| | - Yulia A Nevzorova
- Department of Immunology, Ophthalmology and ENTComplutense University School of MedicineMadridSpain.,Department of Internal Medicine IIIUniversity Hospital RWTHAachenGermany.,12 de Octubre Health Research InstituteMadridSpain
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Villanueva-Paz M, Morán L, López-Alcántara N, Freixo C, Andrade RJ, Lucena MI, Cubero FJ. Oxidative Stress in Drug-Induced Liver Injury (DILI): From Mechanisms to Biomarkers for Use in Clinical Practice. Antioxidants (Basel) 2021; 10:390. [PMID: 33807700 PMCID: PMC8000729 DOI: 10.3390/antiox10030390] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 03/02/2021] [Indexed: 12/11/2022] Open
Abstract
Idiosyncratic drug-induced liver injury (DILI) is a type of hepatic injury caused by an uncommon drug adverse reaction that can develop to conditions spanning from asymptomatic liver laboratory abnormalities to acute liver failure (ALF) and death. The cellular and molecular mechanisms involved in DILI are poorly understood. Hepatocyte damage can be caused by the metabolic activation of chemically active intermediate metabolites that covalently bind to macromolecules (e.g., proteins, DNA), forming protein adducts-neoantigens-that lead to the generation of oxidative stress, mitochondrial dysfunction, and endoplasmic reticulum (ER) stress, which can eventually lead to cell death. In parallel, damage-associated molecular patterns (DAMPs) stimulate the immune response, whereby inflammasomes play a pivotal role, and neoantigen presentation on specific human leukocyte antigen (HLA) molecules trigger the adaptive immune response. A wide array of antioxidant mechanisms exists to counterbalance the effect of oxidants, including glutathione (GSH), superoxide dismutase (SOD), catalase, and glutathione peroxidase (GPX), which are pivotal in detoxification. These get compromised during DILI, triggering an imbalance between oxidants and antioxidants defense systems, generating oxidative stress. As a result of exacerbated oxidative stress, several danger signals, including mitochondrial damage, cell death, and inflammatory markers, and microRNAs (miRNAs) related to extracellular vesicles (EVs) have already been reported as mechanistic biomarkers. Here, the status quo and the future directions in DILI are thoroughly discussed, with a special focus on the role of oxidative stress and the development of new biomarkers.
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Affiliation(s)
- Marina Villanueva-Paz
- Unidad de Gestión Clínica de Gastroenterología, Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga-IBIMA, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, CIBERehd, 29071 Málaga, Spain; (M.V.-P.); (M.I.L.)
| | - Laura Morán
- Department of Immunology, Ophthalmology and ENT, Complutense University School of Medicine, 28040 Madrid, Spain; (L.M.); (N.L.-A.)
- Health Research Institute Gregorio Marañón (IiSGM), 28009 Madrid, Spain
| | - Nuria López-Alcántara
- Department of Immunology, Ophthalmology and ENT, Complutense University School of Medicine, 28040 Madrid, Spain; (L.M.); (N.L.-A.)
| | - Cristiana Freixo
- CINTESIS, Center for Health Technology and Services Research, do Porto University School of Medicine, 4200-319 Porto, Portugal;
| | - Raúl J. Andrade
- Unidad de Gestión Clínica de Gastroenterología, Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga-IBIMA, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, CIBERehd, 29071 Málaga, Spain; (M.V.-P.); (M.I.L.)
| | - M Isabel Lucena
- Unidad de Gestión Clínica de Gastroenterología, Servicio de Farmacología Clínica, Instituto de Investigación Biomédica de Málaga-IBIMA, Hospital Universitario Virgen de la Victoria, Universidad de Málaga, CIBERehd, 29071 Málaga, Spain; (M.V.-P.); (M.I.L.)
| | - Francisco Javier Cubero
- Department of Immunology, Ophthalmology and ENT, Complutense University School of Medicine, 28040 Madrid, Spain; (L.M.); (N.L.-A.)
- 12 de Octubre Health Research Institute (imas12), 28041 Madrid, Spain
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3
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Lamas-Paz A, Morán L, Peng J, Salinas B, López-Alcántara N, Sydor S, Vilchez-Vargas R, Asensio I, Hao F, Zheng K, Martín-Adrados B, Moreno L, Cogolludo A, Gómez Del Moral M, Bechmann L, Martínez-Naves E, Vaquero J, Bañares R, Nevzorova YA, Cubero FJ. Intestinal Epithelial Cell-Derived Extracellular Vesicles Modulate Hepatic Injury via the Gut-Liver Axis During Acute Alcohol Injury. Front Pharmacol 2020; 11:603771. [PMID: 33408632 PMCID: PMC7779758 DOI: 10.3389/fphar.2020.603771] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 10/05/2020] [Indexed: 12/12/2022] Open
Abstract
Binge drinking, i.e., heavy episodic drinking in a short time, has recently become an alarming societal problem with negative health impact. However, the harmful effects of acute alcohol injury in the gut-liver axis remain elusive. Hence, we focused on the physiological and pathological changes and the underlying mechanisms of experimental binge drinking in the context of the gut-liver axis. Eight-week-old mice with a C57BL/6 background received a single dose (p.o.) of ethanol (EtOH) [6 g/kg b.w.] as a preclinical model of acute alcohol injury. Controls received a single dose of PBS. Mice were sacrificed 8 h later. In parallel, HepaRGs and Caco-2 cells, human cell lines of differentiated hepatocytes and intestinal epithelial cells intestinal epithelial cells (IECs), respectively, were challenged in the presence or absence of EtOH [0–100 mM]. Extracellular vesicles (EVs) isolated by ultracentrifugation from culture media of IECs were added to hepatocyte cell cultures. Increased intestinal permeability, loss of zonula occludens-1 (ZO-1) and MUCIN-2 expression, and alterations in microbiota—increased Lactobacillus and decreased Lachnospiraceae species—were found in the large intestine of mice exposed to EtOH. Increased TUNEL-positive cells, infiltration of CD11b-positive immune cells, pro-inflammatory cytokines (e.g., tlr4, tnf, il1β), and markers of lipid accumulation (Oil Red O, srbep1) were evident in livers of mice exposed to EtOH, particularly in females. In vitro experiments indicated that EVs released by IECs in response to ethanol exerted a deleterious effect on hepatocyte viability and lipid accumulation. Overall, our data identified a novel mechanism responsible for driving hepatic injury in the gut-liver axis, opening novel avenues for therapy.
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Affiliation(s)
- Arantza Lamas-Paz
- Department of Immunology, Ophthalmology and ENT, Complutense University School of Medicine, Madrid, Spain.,12 de Octubre Health Research Institute (imas12), Madrid, Spain
| | - Laura Morán
- Department of Immunology, Ophthalmology and ENT, Complutense University School of Medicine, Madrid, Spain.,Servicio de Aparato Digestivo del Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Jin Peng
- Department of Hepatobiliary Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Beatriz Salinas
- Servicio de Aparato Digestivo del Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain.,Bioengineering and Aerospace Engineering Department, Universidad Carlos III de Madrid, Madrid, Spain.,Centro de Investigación Biomédico en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Nuria López-Alcántara
- Department of Immunology, Ophthalmology and ENT, Complutense University School of Medicine, Madrid, Spain
| | - Svenja Sydor
- Department of Internal Medicine, University Hospital Knappschaftskrankenhaus, Ruhr-University Bochum, Bochum, Germany
| | - Ramiro Vilchez-Vargas
- Department of Gastroenterology, Hepatology, and Infectious Diseases, Otto von Guericke University Hospital Magdeburg, Magdeburg, Germany
| | - Iris Asensio
- Servicio de Aparato Digestivo del Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,Centre for Biomedical Research, Network on Liver and Digestive Diseases (CIBEREHD), Madrid, Spain
| | - Fengjie Hao
- Department of Immunology, Ophthalmology and ENT, Complutense University School of Medicine, Madrid, Spain.,12 de Octubre Health Research Institute (imas12), Madrid, Spain.,Department of General Surgery, Hepatobiliary Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Kang Zheng
- Department of Immunology, Ophthalmology and ENT, Complutense University School of Medicine, Madrid, Spain.,12 de Octubre Health Research Institute (imas12), Madrid, Spain.,Department of Anesthesiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Beatriz Martín-Adrados
- Department of Immunology, Ophthalmology and ENT, Complutense University School of Medicine, Madrid, Spain.,12 de Octubre Health Research Institute (imas12), Madrid, Spain
| | - Laura Moreno
- Department of Internal Medicine, University Hospital Knappschaftskrankenhaus, Ruhr-University Bochum, Bochum, Germany.,Department of Pharmacology and Toxicology, Complutense University School of Medicine and Centre for Biomedical Research, Network on Respiratory Diseases (CIBERES), Madrid, Spain
| | - Angel Cogolludo
- Department of Internal Medicine, University Hospital Knappschaftskrankenhaus, Ruhr-University Bochum, Bochum, Germany.,Department of Pharmacology and Toxicology, Complutense University School of Medicine and Centre for Biomedical Research, Network on Respiratory Diseases (CIBERES), Madrid, Spain
| | - Manuel Gómez Del Moral
- 12 de Octubre Health Research Institute (imas12), Madrid, Spain.,Department of Cell Biology, Complutense University School of Medicine, Madrid, Spain
| | - Lars Bechmann
- Department of Internal Medicine, University Hospital Knappschaftskrankenhaus, Ruhr-University Bochum, Bochum, Germany
| | - Eduardo Martínez-Naves
- Department of Immunology, Ophthalmology and ENT, Complutense University School of Medicine, Madrid, Spain.,12 de Octubre Health Research Institute (imas12), Madrid, Spain
| | - Javier Vaquero
- Servicio de Aparato Digestivo del Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,Centre for Biomedical Research, Network on Liver and Digestive Diseases (CIBEREHD), Madrid, Spain
| | - Rafael Bañares
- Servicio de Aparato Digestivo del Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.,Centre for Biomedical Research, Network on Liver and Digestive Diseases (CIBEREHD), Madrid, Spain
| | - Yulia A Nevzorova
- Department of Immunology, Ophthalmology and ENT, Complutense University School of Medicine, Madrid, Spain.,12 de Octubre Health Research Institute (imas12), Madrid, Spain.,Department of Internal Medicine III, University Hospital RWTH Aachen, Aachen, Germany
| | - Francisco Javier Cubero
- Department of Immunology, Ophthalmology and ENT, Complutense University School of Medicine, Madrid, Spain.,12 de Octubre Health Research Institute (imas12), Madrid, Spain
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