Regulation of intestinal senescence during cholestatic liver disease modulates barrier function and liver disease progression

Abstract

Background and AimsSenescence in cholangiocytes and hepatic stellate cells (HSC) has been described during human and murine cholestatic disease, having differential functions; detrimental in biliary cells and anti-fibrotic in HSC. Cholestatic liver disease associates with loss of intestinal barrier function and changes in the microbiome, the mechanistic cause of which is undetermined MethodsIntestinal samples were analysed from control and primary sclerosing cholangitis patients (PSC), wildtype (WT) and p16-3MR transgenic mice. Cholestatic liver disease was induced by bile duct ligation (BDL) and feeding with DDC diet. Fexaramine was used as an intestinal-restricted FXR agonist and antibiotics were given to eliminate the intestinal microbiome. Senescent cells were eliminated in p16-3MR mice with Ganciclovir and in WT mice with the senolytic drug ABT-263. In vitro studies were done in intestinal CaCo-2 cells and organoids were generated from intestinal-crypts isolated from mice. ResultsHere we show increased senescence in intestinal epithelial cells (IEC) in PSC patients and in mice after BDL and DDC diet. Intestinal senescence responded to reduced exposure to bile acids and increased presence of LPS in vitro and in vivo during cholestatic liver disease. Intestinal senescence associated with lower proliferation while increased intestinal stem cell (ISC) activation, as supported by increased organoid growth from ISC. Elimination of senescent cells with genetic and pharmacological approaches exacerbated liver injury and fibrosis during cholestatic liver disease that associated with increased IEC apoptosis and permeability. ConclusionsSenescence occurs in IEC during cholestatic disease and the elimination of senescent cells has a detrimental impact on the gut-liver axis. Our results point to cell-specific rather than systemic targeting of senescence as a therapeutic approach to treat cholestatic liver disease.