Abstract

Background: Activated hepatic stellate cells (aHSCs) regulate the function of immune cells during liver fibrosis. As major innate cells in the liver, macrophages have inducible plasticity. Nevertheless, the mechanisms through which aHSCs regulate macrophages' phenotype and function during liver fibrosis and cirrhosis remain unclear. In this study, we examined the immunoregulatory function of aHSCs during liver fibrosis and explored their role in regulating macrophage phenotype and function.Methods: A total of 96 patients with different stages of chronic hepatitis B-related liver fibrosis were recruited in the study. Metavir score system was used to evaluate the degree of fibrosis. The expression of hepatic CCL2 and M2 phenotype macrophage marker CD163 were detected by immunohistochemistry, and the relationship among hepatic CD163, CCL2, and fibrosis scores were also explored. In the in vitro model, the aHSCs isolated from human liver tissues and THP-1-derived M0-type macrophages (M0MΦ) were co-cultured to observe whether and how aHSCs regulate the phenotype and function of macrophages. To explore whether CCL2/CCR2 axis has a crucial role in macrophage phenotypic changes during liver fibrosis, we treated the M0MΦ with recombinant human CCL2 or its specific receptor antagonist INCB-3284. Furthermore, we used LX2 and TGF-β-activated LX2 to mimic the different activation statuses of aHSCs to further confirm our results.Results: In patients, the infiltration of M2 macrophages increased during the progression of liver fibrosis. Intriguingly, as a key molecule for aHSC chemotactic macrophage aggregation, CCL2 markedly up-regulated the expression of CD163 and CD206 on the macrophages, which was further confirmed by adding the CCR2 antagonist (INCB 3284) into the cell culture system. In addition, the TGF-β stimulated LX2 further confirmed that aHSCs up-regulate the expression of CD163 and CD206 on macrophages. LX2 stimulated with TGF-β could produce more CCL2 and up-regulate other M2 phenotype macrophage-specific markers, including IL-10, ARG-1, and CCR2 besides CD163 and CD206 at the gene level, indicating that the different activation status of aHSCs might affect the final phenotype and function of macrophages.Conclusions: The expression of the M2 macrophage marker increases during liver fibrosis progression and is associated with fibrosis severity. AHSCs can recruit macrophages through the CCL2/CCR2 pathway and induce M2 phenotypic transformation.

Highlights

  • Liver cirrhosis is the eleventh most common cause of mortality worldwide, causing more than 1.16 million deaths annually [1, 2]

  • We found that Activated hepatic stellate cells (aHSCs) aggregate the macrophages through CCL2/CCR2 pathway and induce M2 phenotypic transformation during liver fibrosis

  • To examine the relationship between hepatic M2 macrophages and liver fibrosis stages, we first compared the expression of CD163 in different stages of hepatic fibrosis among patients

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Summary

Introduction

Liver cirrhosis is the eleventh most common cause of mortality worldwide, causing more than 1.16 million deaths annually [1, 2]. The essence of fibrosis is the wound-healing response to chronic inflammation. When this process is dysregulated, excessive scarring occurs in response to persistent injury, leading to altered tissue functions [3, 4]. Impaired liver immune system surveillance, which is the main pathological feature of cirrhosis, occurs primarily due to incomplete and inappropriate activation of immune cells or impaired response of the immune system to pathogens [5,6,7]. Activated hepatic stellate cells (aHSCs) regulate the function of immune cells during liver fibrosis. The mechanisms through which aHSCs regulate macrophages’ phenotype and function during liver fibrosis and cirrhosis remain unclear. We examined the immunoregulatory function of aHSCs during liver fibrosis and explored their role in regulating macrophage phenotype and function

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