研究概要
sCD46是肝脂肪变性的可靠临床标志物,可在血清和血浆样本中方便且无创地检测,这提高了将sCD46水平用作检测或分级肝脂肪变性的诊断方法的可能性。
研究思路结论见上方概要
背景
代谢功能障碍相关脂肪性肝病(MASLD)患病率不断上升,带来了显著的发病率、死亡率和医疗费用负担。在疾病早期进行检测和临床干预可改善预后;然而,目前我们受限于缺乏可靠的诊断检测手段用于人群筛查和监测治疗反应。为满足这一未满足的需求,我们研究了负载脂质的人肝细胞对人类恒定自然杀伤T细胞(iNKT)的激活,进而发现循环可溶性CD46(sCD46)水平能够准确预测肝脂肪变性。
方法
采用新开发的免疫竞争法在两个独立队列中检测血浆sCD46:前瞻性活体肝供者(n = 156;男性 = 66,女性 = 90)和肝肿瘤患者(n = 91;男性 = 58,女性 = 33)。对sCD46水平作为肝脂肪变性预测因子进行统计学评价。
结果
分泌白细胞介素-4(IL-4+)的iNKT细胞在从切除的人肝样本中分离的肝内淋巴细胞中过度富集。IL-4+ iNKT细胞优先在与负载脂肪的肝细胞样细胞系HepaRG共培养中发育。这归因于负载脂肪的HepaRG细胞和原代人肝类器官中基质金属蛋白酶(MMP)的诱导,导致免疫受体的非特异性切割。细胞表面CD46的缺失导致IL-4+ iNKT细胞的分化失去抑制。肝脂肪变性患者的sCD46水平升高。发现了血浆sCD46的区分性截断值,能够根据组织学脂肪变性分级准确分类患者。
展开英文摘要原文
BACKGROUND: The increasing prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) incurs substantial morbidity, mortality and healthcare costs. Detection and clinical intervention at early stages of disease improves prognosis; however, we are currently limited by a lack of reliable diagnostic tests for population screening and monitoring responses to therapy. To address this unmet need, we investigated human invariant Natural Killer T cell (iNKT) activation by fat-loaded hepatocytes, leading to the discovery that circulating soluble CD46 (sCD46) levels accurately predict hepatic steatosis.
METHODS: sCD46 in plasma was measured using a newly developed immuno-competition assay in two independent cohorts: Prospective living liver donors (n = 156; male = 66, female = 90) and patients with liver tumours (n = 91; male = 58, female = 33). sCD46 levels were statistically evaluated as a predictor of hepatic steatosis.
FINDINGS: Interleukin-4-secreting (IL-4 + ) iNKT cells were over-represented amongst intrahepatic lymphocytes isolated from resected human liver samples. IL-4 + iNKT cells preferentially developed in cocultures with a fat-loaded, hepatocyte-like cell line, HepaRG. This was attributed to induction of matrix metalloproteases (MMP) in fat-loaded HepaRG cells and primary human liver organoids, which led to indiscriminate cleavage of immune receptors. Loss of cell-surface CD46 resulted in unrepressed differentiation of IL-4 + iNKT cells. sCD46 levels were elevated in patients with hepatic steatosis. Discriminatory cut-off values for plasma sCD46 were found that accurately classified patients according to histological steatosis grade.
INTERPRETATION: sCD46 is a reliable clinical marker of hepatic steatosis, which can be conveniently and non-invasively measured in serum and plasma samples, raising the possibility of using sCD46 levels as a diagnostic method for detecting or grading hepatic steatosis.
FUNDING: F.B. was supported by the Else Kröner Foundation (Award 2016_kolleg.14). G.G. was supported by the Bristol Myers Squibb Foundation for Immuno-Oncology (Award FA-19-009). N.S. was supported by a Wellcome Trust Fellowship (211113/A/18/Z). J.A.H. received funding from the European Union's Horizon 2020 research and innovation programme (Award 860003). J.M.W. received funding from the Else Kröner Foundation (Award 2015_A10).
论文信息
- 作者
- Bitterer F、Kupke P、Adenugba A、Evert K、Glehr G、Riquelme P、Scheibert L、Preverin G
- 第一作者单位
- Department of Surgery, University Hospital Regensburg, Regensburg 93053, Germany.Germany
- 通讯作者单位
- Department of Surgery, University Hospital Regensburg, Regensburg 93053, Germany. Electronic address: jens.werner@ukr.de.Germany
- 期刊
- EBioMedicine2024 Jun