Liver transcriptional profile of atherosclerosis-related genes in human nonalcoholic fatty liver disease

• Published in: Atherosclerosis 2011-10, Vol.218 (2), p.378-385
• Main Authors: Sookoian, Silvia, Gianotti, Tomas Fernández, Rosselli, Maria Soledad, Burgueño, Adriana L, Castaño, Gustavo O, Pirola, Carlos J
• Format: Article
• Language: English
• Subjects: ACE; Adult; angiogenesis; angiotensin-converting enzyme inhibitors; apoptosis; atherogenesis; Atherosclerosis; Atherosclerosis (general aspects, experimental research); Atherosclerosis - pathology; Biological and medical sciences; Biopsy; Blood and lymphatic vessels; Blood Pressure; Cardiology. Vascular system; Cardiovascular; Cardiovascular Diseases - metabolism; Cardiovascular risk; Case-Control Studies; disease severity; Enalapril; epidemiological studies; fatty liver; Fatty Liver - metabolism; Female; Fibrosis; Gene expression; Gene Expression Regulation; genes; Hepatocytes - cytology; Humans; hypertension; hypoxia; Hypoxia - pathology; immune system; interleukin-4; liver; Liver - metabolism; Liver - pathology; liver cirrhosis; Liver steatosis; Male; Medical sciences; messenger RNA; Middle Aged; NAFLD; NASH; Non-alcoholic Fatty Liver Disease; patients; peptidyl-dipeptidase A; proteins; risk; RNA, Messenger - metabolism; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; TGFB1; transcription (genetics); Transcription, Genetic; Transforming Growth Factor beta1 - genetics
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2011.05.014

Abstract Objectives and design Epidemiological studies have suggested a role of nonalcoholic fatty liver disease (NAFLD) in the development of cardiovascular disease. We evaluated liver mRNA expression of 84 genes encoding proteins involved in the atherosclerosis pathway in patients with NAFLD proven through biopsy in a case-control design, and examined the putative role of the histological disease severity in the molecular events associated with the atherogenic profile. Results Nonalcoholic steatohepatitis (NASH), when compared with simple steatosis (SS), significantly increases the expression of TGFB1 (6.8, p < 0.005), angiotensin I-converting enzyme ( ACE ) (2.1, p < 0.007), LAMA1 (2.1, p < 0.007), SERPINB2 (2.1, p < 0.007), CSF2 (2.5, p < 0.002), IL1A (2.5, p < 0.005), IL3 (2.1, p < 0.007), IL4 (2.1, p < 0.007), LIF (2.1, p < 0.007), and MMP1 (2.1, p < 0.007), and decreases the transcript levels of genes involved in the negative regulation of cell-death pathways. A post hoc analysis of liver biopsies of NASH patients who were treated with enalapril monotherapy because of arterial hypertension showed a significant association with lower fibrosis scores in comparison with untreated patients. BIRC3 , a severe hypoxia-activated gene, was significantly increased in SS (8.2, p < 0.004), when compared with the controls. NASH, but not SS, was also associated with a significant increase in platelet abundance of TGFB1 mRNA. Systems biology analysis revealed highly scored pathways involved in the regulation of programmed cell death, angiogenesis, and immune system, in which TGFB1 was mostly involved. Conclusion NASH, but not SS, may increase atherosclerotic and cardiovascular risk by local overexpression of mediators of atherogenesis, endothelial damage, and regulators of blood pressure; this observation may have therapeutic implications, because ACE inhibitors may improve both cardiovascular outcomes and liver fibrosis. Hepatocyte hypoxia seems to have an important role in the molecular events activated by liver steatosis.