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Nagaya T, Tanaka N, Kimura T, Kitabatake H, Fujimori N, Komatsu M, Horiuchi A, Yamaura T, Umemura T, Sano K, Gonzalez FJ, Aoyama T, Tanaka E. Mechanism of the development of nonalcoholic steatohepatitis after pancreaticoduodenectomy. BBA Clin 2015; 3:168-74. [PMID: 26674248 PMCID: PMC4661550 DOI: 10.1016/j.bbacli.2015.02.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2014] [Revised: 02/05/2015] [Accepted: 02/10/2015] [Indexed: 02/08/2023]
Abstract
Background and aim It is recognized that nonalcoholic fatty liver disease (NAFLD), including nonalcoholic steatohepatitis (NASH), may develop after pancreaticoduodenectomy (PD). However, the mechanism of NASH development remains unclear. This study aimed to examine the changes in gene expression associated with NASH occurrence following PD. Methods The expression of genes related to fatty acid/triglyceride (FA/TG) metabolism and inflammatory signaling was examined using liver samples obtained from 7 post-PD NASH patients and compared with 6 healthy individuals and 32 conventional NASH patients. Results The livers of post-PD NASH patients demonstrated significant up-regulation of the genes encoding CD36, FA-binding proteins 1 and 4, acetyl-coenzyme A carboxylase α, diacylglycerol acyltransferase 2, and peroxisome proliferator-activated receptor (PPAR) γ compared with normal and conventional NASH livers. Although serum apolipoprotein B (ApoB) and TG were decreased in post-PD NASH patients, the mRNAs of ApoB and microsomal TG transfer protein were robustly increased, indicating impaired TG export from the liver as very-low-density lipoprotein (VLDL). Additionally, elevated mRNA levels of myeloid differentiation primary response 88 and superoxide dismutases in post-PD NASH livers suggested significant activation of innate immune response and augmentation of oxidative stress generation. Conclusions Enhanced FA uptake into hepatocytes and lipogenesis, up-regulation of PPARγ, and disruption of VLDL excretion into the circulation are possible mechanisms of steatogenesis after PD. General significance These results provide a basis for understanding the pathogenesis of NAFLD/NASH following PD. The mechanism of NASH development after pancreaticoduodenectomy (PD) was unclear. The gene expression involved in fatty acid uptake and lipogenesis was increased. PPARγ and its target genes were up-regulated in post-PD NASH livers. Impaired triglyceride excretion from the liver was suggested in post-PD NASH. This study proposes possible mechanisms of steatogenesis after PD.
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Key Words
- ACACA, acetyl-CoA carboxylase α
- ACACB, acetyl-CoA carboxylase β
- ACADM, medium-chain acyl-CoA dehydrogenase
- ACOX1, acyl-CoA oxidase 1
- ALT, alanine aminotransferase
- AST, aspartate aminotransferase
- ApoB, apolipoprotein B
- BMI, body mass index
- CAT, catalase
- CPT1A, carnitine palmitoyl-CoA transferase 1α
- CT, computed tomography
- CYBB, cytochrome b-245 β polypeptide
- CYP, cytochrome P450
- CoA, coenzyme A
- DGAT, diacylglycerol acyltransferase
- FA, fatty acid
- FABP, fatty acid-binding protein
- FASN, fatty acid synthase
- Fatty acid
- HADHA, hydroxyacyl-CoA dehydrogenase/3-ketoacyl-CoA thiolase/enoyl-CoA hydratase α
- HBV, hepatitis B virus
- HCV, hepatitis C virus
- HOMA-IR, homeostasis model assessment for insulin resistance
- LPS, lipopolysaccharide
- LXR, liver X receptor
- MCD, methionine- and choline-deficient diet
- MTTP, microsomal triglyceride transfer protein
- MYD88, myeloid differentiation primary response 88
- MyD88
- NAFLD, nonalcoholic fatty liver disease
- NAS, NAFLD activity score
- NASH
- NASH, nonalcoholic steatohepatitis
- PD, pancreaticoduodenectomy
- PPAR, peroxisome proliferator-activated receptor
- PPARGC, PPARγ co-activator
- Pancreaticoduodenectomy
- ROS, reactive oxygen species
- RXR, retinoid X receptor
- SCD, stearoyl-CoA desaturase
- SOD, superoxide dismutase
- SREBF1, sterol regulatory element-binding transcription factor 1
- TG, triglyceride
- TGFB1, transforming growth factor β1
- TLR, Toll-like receptor
- TNF, tumor necrosis factor α
- US, ultrasonography
- VLDL
- VLDL, very-low-density lipoprotein
- qPCR, quantitative polymerase chain reaction
- γGT, gamma-glutamyltransferase
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Affiliation(s)
- Tadanobu Nagaya
- Department of Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Naoki Tanaka
- Department of Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan ; Department of Metabolic Regulation, Shinshu University Graduate School of Medicine, Matsumoto, Japan
| | - Takefumi Kimura
- Department of Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hiroyuki Kitabatake
- Department of Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Naoyuki Fujimori
- Department of Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Michiharu Komatsu
- Department of Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Akira Horiuchi
- Digestive Disease Center, Showa Inan General Hospital, Komagane, Japan
| | - Takahiro Yamaura
- Department of Gastroenterology, Iida Municipal Hospital, Iida, Japan
| | - Takeji Umemura
- Department of Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Kenji Sano
- Department of Laboratory Medicine, Shinshu University Hospital, Matsumoto, Japan
| | - Frank J Gonzalez
- Laboratory of Metabolism, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, United States
| | - Toshifumi Aoyama
- Department of Metabolic Regulation, Shinshu University Graduate School of Medicine, Matsumoto, Japan
| | - Eiji Tanaka
- Department of Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan
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