Copper-transporting ATP7B Research Articles

An Effort to Identify Genetic Determinants in Siblings With Wilson Disease Manifesting Striking Clinical Heterogeneity: An Exome Profiling Study of Two Indian Families

BackgroundWilson disease (WD) is a rare autosomal recessive disorder of copper metabolism caused due to mutations in the copper transporter ATP7B. There is often a striking variability of clinical manifestations among patients with ATP7B mutations, including in siblings. This phenomenon may be caused by individual differences in copper accumulation in hepatocytes and intolerance to copper toxicity as governed by genetic variations in copper metabolism genes acting as modifier loci to the disease. ObjectiveTo elucidate the genetic basis of striking clinical heterogeneity among two siblings of two families with WD. MethodsThe disease diagnosis and subsequent clinical examinations were performed by expert clinicians. The younger siblings in both families presented with early neurological manifestations at a younger age than their older siblings. Interestingly, only the younger siblings were reported to have had hepatic manifestations. Exome sequencing of all the four individuals was performed to understand their heterogeneous phenotypic outcomes. ResultsGenetic screening revealed no difference in the ATP7B variant spectrum between the siblings of each family. However, the siblings of both the families were found to harbor mutually exclusive pathogenic variants in suspected modifier genes implicated in copper metabolism and/or other neurological and hepatic disorders having overlapping symptoms with WD, viz., CFTR, PPARG, ABCB11, ATP7A, CYP2D6, mTOR, TOR1A, and CP, which can potentially explain their differential clinical phenotypes. ConclusionClinical heterogeneity between siblings with WD with the same ATP7B mutation profile may be attributed to the presence of different pathogenic variants in potential modifier genes.

Copper overload induces apoptosis and impaired proliferation of T cell in zebrafish

Copper is an essential biometal for cell development and function, however, unbalanced copper homeostasis in T cell development and the underlying mechanisms are largely unexplored. Here, we use a zebrafish model to investigate the effect of copper overload in T cell development. We show that copper stressed zebrafish larvae exhibit a significant reduction in T cells with increased cell apoptosis and impaired cell proliferation. T cell progenitors, hematopoietic stem and progenitor cells, also exhibit increased cell apoptosis. Copper overload induces production of ROS and the down-regulations of its resistance genes foxos, and ectopic expression of foxo3a, ROS scavenger GSH, could both effectively rescue the reduction of T cells in copper overload larvae. Moreover, foxm1-cytoskeleton axis, parallel to ROS-foxo axis, also mediates the copper overload induced T cell developmental defects. Meanwhile, ROS destroys expression of cytoskeleton rather than of foxm1 in the cells to induce cell apoptosis and the impaired proliferation. The functional integrity of copper transporters cox17 and atp7b are required for copper stress in inducing T cell apoptosis and proliferation impairment. Our findings demonstrate that the down-stream ROS-foxo/cytoskeleton and foxm1-cytoskeleton signaling pathways contribute jointly to copper overload induced T cell apoptosis and proliferation defects, which are depend on the integral function of Cox17 and Atp7b, and provide new insight into the copper homeostasis in T lymphocyte development.

Genome editing without nucleases confers proliferative advantage to edited hepatocytes and corrects Wilson disease.

Application of classic liver-directed gene replacement strategies is limited in genetic diseases characterized by liver injury due to hepatocyte proliferation resulting in decline of therapeutic transgene expression and potential genotoxic risk. Wilson disease (WD) is a life-threating autosomal disorder of copper homeostasis caused by pathogenic variants in copper transporter ATP7B and characterized by toxic copper accumulation, resulting in severe liver and brain diseases. Genome editing holds promise for the treatment of WD, nevertheless to rescue copper homeostasis ATP7B function must be restored in at least 25% of the hepatocytes, which surpasses by far genome editing correction rates. We applied a liver-directed nuclease-free genome editing approach, based on adeno-associated viral vector (AAV) -mediated targeted integration of a promoterless mini-ATP7B cDNA into the Alb locus. Administration of AAV-Alb-mini-ATP7B in two WD mouse models resulted in extensive liver repopulation by genome edited hepatocytes holding a proliferative advantage over non-edited ones, and ameliorated liver injury and copper metabolism. Furthermore, combination of genome editing with a copper chelator currently used for WD treatment, achieved greater disease improvement compared to chelation therapy alone. Nuclease-free genome editing provided therapeutic efficacy and may represent a safer and longer lasting alternative to classic gene replacement strategies for WD.

Headache as the sole manifestation of Wilson’s disease

Wilson’s disease (WD) is an inborn error of copper metabolism caused by a mutation to the copper-transporting gene ATP7B. In the first decade of life, hepatic involvement predominates but neurological manifestations occur in the third or fourth decades. Studies showed Indian children with neuro WD present with behavior abnormality, speech and cognitive impairment, sub-clinical affection of visual pathway, and autonomic function. As a treatable disease, WD should be detected early in the course of the disease by any health professional at any care level, but the rare prevalence of the disease explains the lack of awareness of this disease. Even a high index of suspicion about this entity gets more difficult when the rare and atypical symptom is the only presentation of the disease. Here, we present the case of a 15-year-old girl with worsening headache for the past 3 months as the only neurological manifestation of WD, and that also without any evidence of hepatic involvement.

Cuproptosis is involved in copper-induced hepatotoxicity in chickens

Copper (Cu) is an essential trace element, but it is also a ubiquitous environmental pollutant that threatens public health. Cuproptosis is a recently discovered cell death mode that unlike other programmed cell death, characterized by proteotoxic stress due to lipoylated protein aggregation and iron-sulfur cluster protein loss. Chickens as a high-trophic-level non-mammalian vertebrate that easily absorb and accumulate copper from the environment and food, but it is unclear whether the underlying molecular mechanisms that cause their hepatotoxicity under natural copper stress are related to cuproptosis. Therefore, we established animal models of chickens with different concentrations of copper exposure to dissect the role and mechanism of cuproptosis in chicken hepatotoxicity under natural copper stress. Our histopathological and biochemical results demonstrated that the liver structure with copper-treated exhibited dose-dependent damage. Meanwhile, copper treatment also dramatically increased serum and liver copper content and activated the expression of the membrane-associated copper transporter ATP7B. Furthermore, we found that Cu-exposure significantly increased the MDA content, and reduced the levels of T-AOC and SOD in serum and liver. Additionally, we found that the mRNA and protein levels of FDX1 were significantly upregulated in the 220 and 330 mg/kg Cu-treated groups. In our further studies, we found that copper did not alter protein levels of DLAT and DLST in chicken liver, but significantly increased Lipoylated-DLAT levels and oligomerization of Lipoylated-DLAT in the 330 mg/kg Cu-treatment group. Overall, we identified that FDX1-mediated protein lipoylation and proteotoxic stress indeed participate in copper-induced hepatotoxicity in chickens. Our results present novel insight into the pathogenesis of copper-induced hepatotoxicity in chickens and provide data to support filling in the role of cuproptosis in birds.

Stimulation of Liver Fibrosis by N2 Neutrophils in Wilson’s Disease

Wilson's disease is an inherited hepatoneurologic disorder caused by mutations in the copper transporter ATP7B. Liver disease from Wilson's disease is one leading cause of cirrhosis in adolescents. Current copper chelators and zinc salt treatments improve hepatic presentations but frequently worsen neurologic symptoms. In this study, we showed the function and machinery of neutrophil heterogeneity using a zebrafish/murine/cellular model of Wilson's disease. We investigated the neutrophil response in atp7b-/- zebrafish by live imaging, movement tracking, and transcriptional analysis in sorted cells. Experiments were conducted to validate liver neutrophil heterogeneity in Atp7b-/- mice. Invitro experiments were performed in ATP7B-knockout human hepatocellular carcinomas G2 cells and isolated bone marrow neutrophils to reveal the mechanism of neutrophil heterogeneity. Recruitment of neutrophils into the liver is observed in atp7b-/- zebrafish. Pharmacologic stimulation of neutrophils aggravates liver and behavior defects in atp7b-/- zebrafish. Transcriptional analysis in sorted liver neutrophils from atp7b-/- zebrafish reveals a distinct transcriptional profile characteristic of N2 neutrophils. Furthermore, liver N2 neutrophils also were observed in ATP7B-knockout mice, and pharmacologically targeted transforming growth factor β1, DNA methyltransferase, or signal transducer and activator of transcription 3 reduces liver N2 neutrophils and improves liver function and alleviates liver inflammation and fibrosis in ATP7B-knockout mice. Epigenetic silencing of Socs3 expression by transforming growth factor β1 contributes to N2-neutrophil polarization in isolated bone marrow neutrophils. Our findings provide a novel prospect that pharmacologic modulation of N2-neutrophil activity should be explored as an alternative therapeutic to improve liver function in Wilson's disease.

Case report on Wilson’s disease with hepatic encephalopathy and type 1 hepatorenal syndrome

An uncommon inherited condition of copper metabolism is known as Wilson disease. The copper-transporting enzyme ATP7B, which is mostly found in the liver and brain, has undergone several mutations that result in hereditary abnormality. Clinical symptoms are loss of vision for 2 days, and after eye examination, there was a yellowish discoloration in the eye. The patient did not want to eat anything due to the disease condition, and he has been having a loss of appetite for 2 days. Early infancy to young adulthood and even later ages can see the start of the condition. Clinical, biochemical, and molecular indicators are used in conjunction to make the clinical diagnosis. Early or even better pre-symptomatic disease stages are when chelating medicines and zinc salts are most useful as a treatment.

Copper binding leads to increased dynamics in the regulatory N-terminal domain of full-length human copper transporter ATP7B.

ATP7B is a human copper-transporting P1B-type ATPase that is involved in copper homeostasis and resistance to platinum drugs in cancer cells. ATP7B consists of a copper-transporting core and a regulatory N-terminal tail that contains six metal-binding domains (MBD1-6) connected by linker regions. The MBDs can bind copper, which changes the dynamics of the regulatory domain and activates the protein, but the underlying mechanism remains unknown. To identify possible copper-specific structural dynamics involved in transport regulation, we constructed a model of ATP7B spanning the N-terminal tail and core catalytic domains and performed molecular dynamics (MD) simulations with (holo) and without (apo) copper ions bound to the MBDs. In the holo protein, MBD2, MBD3 and MBD5 showed enhanced mobilities, which resulted in a more extended N-terminal regulatory region. The observed separation of MBD2 and MBD3 from the core protein supports a mechanism where copper binding activates the ATP7B protein by reducing interactions among MBD1-3 and between MBD1-3 and the core protein. We also observed an increased interaction between MBD5 and the core protein that brought the copper-binding site of MBD5 closer to the high-affinity internal copper-binding site in the core protein. The simulation results assign specific, mechanistic roles to the metal-binding domains involved in ATP7B regulation that are testable in experimental settings.

Full-length ATP7B reconstituted through protein trans-splicing corrects Wilson disease in mice

Wilson disease (WD) is a genetic disorder of copper homeostasis, caused by deficiency of the copper transporter ATP7B. Gene therapy with recombinant adeno-associated vectors (AAV) holds promises for WD treatment. However, the full-length human ATP7B gene exceeds the limited AAV cargo capacity, hampering the applicability of AAV in this disease context. To overcome this limitation, we designed a dual AAV vector approach using split intein technology. Split inteins catalyze seamless ligation of two separate polypeptides in a highly specific manner. We selected a DnaE intein from Nostoc punctiforme (Npu) that recognizes a specific tripeptide in the human ATP7B coding sequence. We generated two AAVs expressing either the 5′-half of a codon-optimized human ATP7B cDNA followed by the N-terminal Npu DnaE intein or the C-terminal Npu DnaE intein followed by the 3′-half of ATP7B cDNA, under the control of a liver-specific promoter. Intravenous co-injection of the two vectors in wild-type and Atp7b−/− mice resulted in efficient reconstitution of full-length ATP7B protein in the liver. Moreover, Atp7b−/− mice treated with intein-ATP7B vectors were protected from liver damage and showed improvements in copper homeostasis. Taken together, these data demonstrate the efficacy of split intein technology to drive the reconstitution of full-length human ATP7B and to rescue copper-mediated liver damage in Atp7b−/− mice, paving the way to the development of a new gene therapy approach for WD.

Wilson Disease: Update on Pathophysiology and Treatment.

Wilson disease (WD) is a potentially fatal genetic disorder with a broad spectrum of phenotypic presentations. Inactivation of the copper (Cu) transporter ATP7B and Cu overload in tissues, especially in the liver, are established causes of WD. However, neither specific ATP7B mutations nor hepatic Cu levels, alone, explain the diverse clinical presentations of WD. Recently, the new molecular details of WD progression and metabolic signatures of WD phenotypes began to emerge. Studies in WD patients and animal models revealed the contributions of non-parenchymal liver cells and extrahepatic tissues to the liver phenotype, and pointed to dysregulation of nuclear receptors (NR), epigenetic modifications, and mitochondria dysfunction as important hallmarks of WD pathogenesis. This review summarizes recent advances in the characterization of WD pathophysiology and discusses emerging targets for improving WD diagnosis and treatment.

Structure of the Wilson disease copper transporter ATP7B.

ATP7A and ATP7B, two homologous copper-transporting P1B-type ATPases, play crucial roles in cellular copper homeostasis, and mutations cause Menkes and Wilson diseases, respectively. ATP7A/B contains a P-type ATPase core consisting of a membrane transport domain and three cytoplasmic domains, the A, P, and N domains, and a unique amino terminus comprising six consecutive metal-binding domains. Here, we present a cryo–electron microscopy structure of frog ATP7B in a copper-free state. Interacting with both the A and P domains, the metal-binding domains are poised to exert copper-dependent regulation of ATP hydrolysis coupled to transmembrane copper transport. A ring of negatively charged residues lines the cytoplasmic copper entrance that is presumably gated by a conserved basic residue sitting at the center. Within the membrane, a network of copper-coordinating ligands delineates a stepwise copper transport pathway. This work provides the first glimpse into the structure and function of ATP7 proteins and facilitates understanding of disease mechanisms and development of rational therapies.

Copper-dependent ATP7B N-terminal domain dynamics in two reaction-cycle intermediates

Membrane proteins control the flow of ions across biological membranes by selective import or export and are of vital importance for all living cells. Disturbances in ion transport can cause severe diseases such as Wilson’s disease, which is caused by mutations in the human copper-transporting P-type ATPase ATP7B. ATP7B activity is regulated by a dynamic N-terminal domain consisting of six metal binding domains (MBDs) that move as rigid bodies and interact transiently with each other and the core transporter in a copper-dependent manner.

Hepatic Steatosis in the Mouse Model of Wilson Disease Coincides with a Muted Inflammatory Response

Wilson disease (WND) is caused by inactivation of the copper transporter ATP7B and copper accumulation in tissues. WND presentations vary from liver steatosis to inflammation, fibrosis, and liver failure. Diets influence the liver phenotype in WND, but findings are inconsistent. To better understand the impact of excess calories on liver phenotype in WND, the study compared C57BL/6J Atp7b-/- and C57BL/6J mice fed for 12 weeks with Western diet or normal chow. Serum and liver metabolites, bodyfat content, liver histology, hepatic proteome, and copper content were analyzed. Wild-type and Atp7b-/- livers showed striking similarities in their responses to Western diet, most notably down-regulation of cholesterol biosynthesis, altered nuclear receptor signaling, and changes in cytoskeleton. Western diet increased body fat content and induced liver steatosis in males and females regardless of genotype; however, the effects were less pronounced in Atp7b-/- mice compared with those in the wild type mice. Although hepatic copper remained elevated in Atp7b-/- mice, liver inflammation was reduced. The diet diminished signaling by Rho GTPases, integrin, IL8, and reversed changes in cell cycle machinery and cytoskeleton. Overall, high calories decreased inflammatory response in favor of steatosis without improving markers of cell viability. Similar changes of cellular pathways during steatosis development in wild-type and Atp7b-/- mice explain histologic overlap between WND and non-alcoholic fatty liver disease despite opposite copper changes in these disorders.

AYURVEDIC PROTOCOL FOR THE MANAGEMENT OF WILSON’S DISEASE – A CASE REPORT

Wilson’s disease (hepatolenticular degeneration) is a rare important autosomal recessive disorder caused by dys- function of the copper transporter ATP7B, which leads to snagging in copper transport by the hepatic lysosomes resulted in the deposition of copper in the brain, liver, kidney, or skeletal system. The symptoms are jaundice, Kayser-Fleischer rings, dysarthria, ataxia, and muscle spasticity etc. Current therapeutic modalities for the manage- ment of Wilson's disease include zinc, trientine, penicillamine etc. In Ayurvedic classics there is no exact correlation is available for this disease entity that exactly matches the feature of Wilson disease, but it can be correlated with Vatavyadhi under the Sahaja Vyadhi (Heredity) or Janamjata Vyadhi (congenital). The treatment1 mentioned for Vatavyadhi is Snehana (oleation), Mrudu Swedana (mild sedation), Anuvasana Basti (oil enema) and Niruha Basti (Decoction Enema). Material and methods: An 18-year-old male patient with Wilson disease complained of short stepping gait, persistent constipation, tremors, changed speech, generalised stiffness, and frequent eye blinking. S. Ceruloplasmin was found to be 18.33 mg/dL (usually 20 mg/dl to 40 mg/dl), S. copper was found to be within normal limits, and a slit lamp assay for the KF ring was negative. Ayurvedic therapy was used in conjunction with oral medicine throughout the treatment. Results: Clinical observations revealed that the patient's earlier symptoms had significantly improved, and he was able to carry out his usual activities with ease. Duration of treatment:three months. Conclusion: From the case study it can be concluded that the Ayurvedic medications and Panchkarma therapy in such patients may help in providing supportive care and improving the quality of life. Keywords: Vatavyadhi, Shaman Chikitsa, Bastikarma, Wilson's disease.

Hepatic drug-metabolizing enzymes and drug transporters in Wilson\u2019s disease patients with liver failure

BackgroundWilson’s disease is a genetic disorder inherited in a recessive manner, caused by mutations in the copper-transporter ATP7B. Although it is a well-known disease, currently available treatments are far from satisfactory and their efficacy varies in individual patients. Due to the lack of information about drug-metabolizing enzymes and drug transporters profile in Wilson’s disease livers, we aimed to evaluate the mRNA expression and protein abundance of selected enzymes and drug transporters in this liver disorder.MethodsWe analyzed gene expression (qPCR) and protein abundance (LC–MS/MS) of 14 drug-metabolizing enzymes and 16 drug transporters in hepatic tissue from Wilson’s disease patients with liver failure (n = 7, Child–Pugh class B and C) and metastatic control livers (n = 20).ResultsIn presented work, we demonstrated a downregulation of majority of CYP450 and UGT enzymes. Gene expression of analyzed enzymes ranged between 18 and 65% compared to control group and significantly lower protein content of CYP1A1, CYP1A2, CYP2C8, CYP2C9, CYP3A4 and CYP3A5 enzymes was observed in Wilson’s disease. Moreover, a general decrease in hepatocellular uptake carriers from SLC superfamily (significant at protein level for NTCP and OATP2B1) was observed. As for ABC transporters, the protein abundance of BSEP and MRP2 was significantly lower, while levels of P-gp and MRP4 transporters were significantly higher in Wilson’s disease.ConclusionsAltered hepatic expression of drug‐metabolizing enzymes and drug transporters in Wilson’s disease patients with liver failure may result in changes of drug pharmacokinetics in that group of patients.

Copper ions impair zebrafish skeletal myofibrillogenesis via epigenetic regulation.

Unbalanced copper (Cu2+ ) homeostasis is associated with the developmental defects of vertebrate myogenesis, but the underlying molecular mechanisms remain elusive. In this study, it was found that Cu2+ stressed zebrafish embryos and larvae showed reduced locomotor speed as well as loose and decreased myofibrils in skeletal muscle, coupled with the downregulated expression of muscle fiber markers mylpfa and smyhc1l and the irregular arrangement of myofibril and sarcomere. Meanwhile, the Cu2+ stressed zebrafish embryos and larvae also showed significant reduction in the expression of H3K4 methyltransferase smyd1b transcripts and H3K4me3 protein as well as in the binding enrichment of H3K4me3 on gene mylpfa promoter in skeletal muscle cells, suggesting that smyd1b-H3K4me3 axis mediates the Cu2+ -induced myofibrils specification defects. Additionally, whole genome DNA methylation sequencing unveiled that the gene smyd5 exhibited significant promoter hyper-methylation and increased expression in Cu2+ stressed embryos, and the ectopic expression of smyd5 in zebrafish embryos also induced the myofibrils specification defects as those observed in Cu2+ stressed embryos. Moreover, Cu2+ was shown to suppress myofibrils specification and smyd1b promoter transcriptional activity directly independent of the integral function of copper transporter cox17 and atp7b. All these data may shed light on the linkage of unbalanced copper homeostasis with specific gene promoter methylation and epigenetic histone protein modification as well as the resultant signaling transduction and the myofibrillogenesis defects.

Maladie de Wilson

AbstractWilson’s disease is a autosomal recessive inherited disorder that causes progressive copper overload. The ATP7B gene carried on chromosome 13 encodes an intracellular copper transporter ATP7B protein that allows cellular excretion of excess copper. In Wilson’s disease, the functional deficiency of ATP7B causes a failure in the elimination of copper from the bile, which then accumulates in the liver and is then released in free form into the bloodstream. Wilson’s disease is therefore an initially hepatic disorder which can progress to multisystem involvement with an accumulation of copper in the brain, eye, kidney, etc. if it is not diagnosed early. The first symptoms are most often hepatic in children and neurological in adults. The diagnosis is made on a bundle of clinical, biological and radiological arguments. Interpretation of the cupric balance, typically associating a decrease in ceruloplasminemia and total cupremia with an increase in 24-hour urinary copper excretion, can be difficult, justifying the determination of the free or exchangeable copper. The ratio of exchangeable copper/total copper or REC (relative exchangeable copper) is an excellent diagnostic biomarker. Molecular biology can confirm the diagnosis in 98 % of cases. The treatments combine a copper low diet, copper chelators or zinc salts. Liver transplantation is the treatment for fulminant liver forms and decompensated cirrhosis. This rare genetic disease has a good prognosis if treatment is started early and continued all lifelong. It is therefore important to know the clinical manifestations of the disease and the diagnostic tests in order to evoke it quickly and to then ensure regular clinical and laboratory monitoring of patients.

Systemic Deletion of Atp7b Modifies the Hepatocytes’ Response to Copper Overload in the Mouse Models of Wilson Disease

Wilson disease (WD) is a genetic disorder caused by inactivation of the copper (Cu) transporter Atp7b and Cu overload, especially in the liver. Mice with Atp7b deleted either globally (systemic inactivation) or only in hepatocyte recapitulate various aspects of human WD. However, their phenotypes vary, and neither the common response to Cu overload nor factors responsible for phenotypes variability are well defined. Using metabolic, histologic, and proteome analyses in three mouse strains with mutated Atp7b, we show that global inactivation of Atp7b enhances and specifically modifies the hepatocyte response. The loss of Atp7b only in hepatocytes dysregulates lipid and nucleic acid metabolisms and increases the abundance of respiratory chain components and redox balancing enzymes. In global knockouts, independently of the background strain, the metabolism of lipid, nucleic acid, and amino acid is inhibited, respiratory chain components are down-regulated, inflammatory response and regulation of chromosomal replication are enhanced. Decrease in glucokinase and lathosterol oxidase and elevation of mucin-13 and S100A10 are observed in all Atp7b mutant strains and reflects the extent of liver injury. The magnitude of proteome changes in different Atp7b-/- strains and in individual animals inversely correlates with their metallothioneins levels rather than Cu content. These results augment the current model of WD pathogenesis, facilitate the identification of WD-specific markers, and assist the development of new therapies

Hypoxia Active Platinum(IV) Prodrugs of Orotic Acid Selective to Liver Cancer Cells.

Platinum(IV) complexes of orotic acid selectively target liver cancer cells displaying enhanced activity and higher uptake in Hep G2. The comparatively higher expression of Organic Anion Transporter 2 (OAT2) in Hep G2 and decrease in toxicity in the presence of OAT2 inhibitor suggest its involvement in the uptake of the complexes. They are resistant to sequestration by the copper transporter ATP7B, unlike cisplatin and oxaliplatin.

Systemic deletion of Atp7b modifies the hepatocytes\u2019 response to copper overload in the mouse models of Wilson disease

Wilson disease (WD) is caused by inactivation of the copper transporter Atp7b and copper overload in tissues. Mice with Atp7b deleted either globally (systemic inactivation) or only in hepatocyte recapitulate various aspects of human disease. However, their phenotypes vary, and neither the common response to copper overload nor factors contributing to variability are well defined. Using metabolic, histologic, and proteome analyses in three Atp7b-deficient mouse strains, we show that global inactivation of Atp7b enhances and specifically modifies the hepatocyte response to Cu overload. The loss of Atp7b only in hepatocytes dysregulates lipid and nucleic acid metabolisms and increases the abundance of respiratory chain components and redox balancing enzymes. In global knockouts, independently of their background, the metabolism of lipid, nucleic acid, and amino acids is inhibited, respiratory chain components are down-regulated, inflammatory response and regulation of chromosomal replication are enhanced. Decrease in glucokinase and lathosterol oxidase and elevation of mucin-13 and S100A10 are observed in all Atp7b mutant strains and reflect the extent of liver injury. The magnitude of proteomic changes in Atp7b−/− animals inversely correlates with the metallothioneins levels rather than liver Cu content. These findings facilitate identification of WD-specific metabolic and proteomic changes for diagnostic and treatment.