MERTK rs4374383 polymorphism affects the severity of fibrosis in non-alcoholic fatty liver disease

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• 作者：Salvatore Petta<sup>1sup><sup> ; sup><sup>petsa@inwind.it" class="auth_mail" title="E-mail the corresponding authorsup> ; Luca Valenti<sup>2sup> ; Fabio Marra<sup>3sup> ; Stefania Grimaudo<sup>1sup> ; Claudio Tripodo<sup>4sup> ; Elisabetta Bugianesi<sup>5sup> ; Calogero Cammà ; <sup>1sup> ; Andrea Cappon<sup>3sup> ; Vito Di Marco<sup>1sup> ; Giovanni Di Maira<sup>3sup> ; Paola Dongiovanni<sup>2sup> ; Raffaela Rametta<sup>2sup> ; Alessandro Gulino<sup>4sup> ; Enrico Mozzi<sup>2sup> ; Emanuele Orlando<sup>1sup> ; Marco Maggioni<sup>6sup> ; Rosaria Maria Pipitone<sup>1sup> ; Silvia Fargion<sup>2sup> ; Antonio Crax&igrave ; <sup>1sup>
• 关键词：MERTK ; myeloid-epithelial-reproductive tyrosine kinase ; PNPLA3 ; patatin-like phospholipase-3 ; IR ; insulin resistance ; NAFLD ; non-alcoholic fatty liver disease ; NASH ; non-alcoholic steatohepatitis ; HOMA ; homeostasis model assessment
• 刊名：Journal of Hepatology
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：64
• 期：3
• 页码：682-690
• 全文大小：1372 K

文摘

Homozygosity for a common non-coding rs4374383 G>A polymorphism in MERTK (myeloid-epithelial-reproductive tyrosine kinase) has been associated with the protection against fibrosis progression in chronic hepatitis C. The main study objective was to assess whether MERTK AA genotype influences liver fibrosis, and secondarily MERTK expression in patients with non-alcoholic fatty liver disease (NAFLD). We also investigated whether MERTK is expressed in human hepatic stellate cells (HSC) and in murine models of fibrogenesis.

sSec_2">Methods

sp0010">We considered 533 consecutive patients who underwent liver biopsy for suspected non-alcoholic steatohepatitis (NASH) without severe obesity from two Italian cohorts. As controls, we evaluated 158 patients with normal liver enzymes and without metabolic disturbances. MERTK rs4374383 genotype was assessed by 5′-nuclease assays. MERTK expression was analysed in mouse models of fibrosis, and the effect of the MERTK ligand GAS6 were investigated in human HSC.

sSec_3">Results

sp0015">Clinically significant fibrosis (stage F2-F4) was observed in 19% of patients with MERTK AA compared to 30% in those with MERTK GG/GA (OR 0.43, CI 0.21&ndash;0.88, p = 0.02; adjusted for centre, and genetic, clinical-metabolic and histological variables). The protective rs4374383 AA genotype was associated with lower MERTK hepatic expression. MERTK was overexpressed in the liver of NAFLD patients with F2-F4 fibrosis and in in vivo models of fibrogenesis. Furthermore, exposure of cultured human HSC to the MERTK ligand GAS6, increased cell migration and induced procollagen expression. These effects were counteracted by inhibition of MERTK activity, which also resulted in apoptotic death of HSC.

sSec_4">Conclusions

sp0020">The rs4374383 AA genotype, associated with lower intrahepatic expression of MERTK, is protective against F2-F4 fibrosis in patients with NAFLD. The mechanism may involve modulation of HSC activation.