Transcriptomic changes in liver transplant recipients with non-alcoholic steatohepatitis indicate dysregulation of wound healing

Front Endocrinol (Lausanne). 2023 May 8:14:1111614. doi: 10.3389/fendo.2023.1111614. eCollection 2023.

Abstract

Background: Non-alcoholic steatohepatitis (NASH) has become a leading indication for liver transplantation. However, it often recurs in the graft and can also arise de novo in individuals transplanted for other indications. Post-transplant NASH (PT-NASH) is more aggressive and leads to accelerated fibrosis. The mechanistic basis of PT-NASH has not yet been defined and no specific therapeutic strategies are currently available.

Methods: Here, we profiled the transcriptomes of livers with PT-NASH from liver transplant recipients to identify dysregulated genes, pathways, and molecular interaction networks.

Results: Transcriptomic changes in the PI3K-Akt pathway were observed in association with metabolic alterations in PT-NASH. Other significant changes in gene expression were associated with DNA replication, cell cycle, extracellular matrix organization, and wound healing. A systematic comparison with non-transplant NASH (NT-NASH) liver transcriptomes indicated an increased activation of wound healing and angiogenesis pathways in the post-transplant condition.

Conclusion: Beyond altered lipid metabolism, dysregulation of wound healing and tissue repair mechanisms may contribute to the accelerated development of fibrosis associated with PT-NASH. This presents an attractive therapeutic avenue to explore for PT-NASH to optimize the benefit and survival of the graft.

Keywords: computational biology & bioinformatics; disease pathogenesis; fibrosis; liver transplantation; non-alcoholic fatty liver disease; non-alcoholic steatohepatitis; transcriptomics (RNA-seq); wound healing.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Gene Expression Profiling
  • Humans
  • Liver Transplantation*
  • Non-alcoholic Fatty Liver Disease* / genetics
  • Phosphatidylinositol 3-Kinases
  • Transcriptome

Substances

  • Phosphatidylinositol 3-Kinases

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