Abstract

BackgroundNon-alcoholic steatohepatitis (NASH) is associated with hepatic fibrogenesis. Despite well-known cholesterol-lowering action of statins, their mechanisms against NASH-mediated fibrogenesis remain unclear. This study aimed at investigating the in vitro and in vivo anti-fibrotic properties of fluvastatin (Flu).MethodsPalmitate (PA)-induced changes in intracellular hydrogen peroxide levels in primary rat hepatocytes (PRHs) and human hepatoma cell line (HepG2) were quantified by dichlorofluorescein diacetate (DCF-DA) dye assay, whereas changes in expressions of NADPH oxidase gp91phox subunit, α-smooth muscle actin (α-SMA), and NFκB p65 nuclear translocation were quantified with Western blotting. Quantitative real-time polymerase chain reaction (q-PCR) was used to investigate mRNA expressions of pro-inflammatory genes (ICAM-1, IL-6, TNF-α). Conditioned medium (CM) from PA-treated PRHs was applied to cultured rat hepatic stellate cell line, HSC-T6, with or without Flu-pretreatment for 2 h. Pro-fibrogenic gene expressions (COL1, TIMP-1, TGF-β1, α-SMA) and protein expression of α-SMA were analyzed. In vivo study using choline-deficient L-amino acid defined (CDAA) diet-induced rat NASH model was performed by randomly assigning Wistar rats (n = 28) to normal controls (n = 4), CDAA diet with vehicles, and CDAA diet with Flu (5 mg/kg or 10 mg/kg) (n = 8 each) through gavage for 4 or 8 weeks. Livers were harvested for histological, Western blot (α-SMA), and q-PCR analyses for expressions of pro-inflammatory (IL-6, iNOS, ICAM-1) and pro-fibrogenic (Col1, α-SMA, TIMP-1) genes.ResultsIn vitro, Flu (1–20 μM) inhibited PA-induced free-radical production, gp91phox expression, and NFκB p65 translocation in HepG2 and PRHs, while CM-induced α-SMA protein expression and pro-fibrogenic gene expressions in HSC-T6 were suppressed in Flu-pretreated cells compared to those without pretreatment. Moreover, α-SMA protein expression was significantly decreased in HSC-T6 cultured with CM from PA-Flu-treated PRHs compared to those cultured with CM from PA-treated PRHs. Flu also reduced steatosis and fibrosis scores, α-SMA protein expression, mRNA expression of pro-inflammatory and pro-fibrogenic genes in livers of CDAA rats.ConclusionsWe demonstrated PA-induced HSC activation through paracrine effect of hepatocyte in vitro that was significantly suppressed by pre-treating HSC with Flu. In vivo, Flu alleviated steatosis-induced HSC activation and hepatic fibrogenesis through mitigating inflammation and oxidative stress, suggesting possible therapeutic role of Flu against NASH.

Highlights

  • Non-alcoholic steatohepatitis (NASH) is associated with hepatic fibrogenesis

  • NASH is known to be associated with an increased generation of reactive oxygen species [5] through nicotinamide adenine dinucleotide phosphate (NADPH) oxidase-mediated pathways that play a crucial role in the development of hepatic fibrogenesis [6]

  • Flu attenuates PA-induced oxidative stress, inflammatory responses, and fibrogenesis Inhibition of reactive oxygen species (ROS) production and NADPH oxidase gp91phox expression in PA-treated HepG2 and Primary rat hepatocyte (PRH) by Flu To demonstrate the anti-fibrotic roles of Flu in steatosisinduced liver fibrosis, the beneficial effects of Flu on lipidinduced hepatocyte damage were first investigated

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Summary

Introduction

Non-alcoholic steatohepatitis (NASH) is associated with hepatic fibrogenesis. Non-alcoholic fatty liver disease (NAFLD) has become a public health issue because of the ongoing epidemics of obesity and type 2 diabetes. According to the “two-hit-hypothesis” of non-alcoholic steatohepatitis (NASH), hepatic steatosis (“first hit”) is a prerequisite for the development of subsequent adverse events (“second hit”) when combined with unfavorable environmental and genetic factors, leading to inflammatory liver damage and fibrogenesis in NASH [2]. NASH is known to be associated with an increased generation of reactive oxygen species [5] through nicotinamide adenine dinucleotide phosphate (NADPH) oxidase-mediated pathways that play a crucial role in the development of hepatic fibrogenesis [6]. Recent studies have shown that modulation of lipid homeostasis and suppression of NFκB activation counteract the progression of liver injury in experimental NASH model [9]

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