Non-alcoholic steatohepatitis (NASH) is the most common cause of chronic liver diseases with its pathophysiological mechanism poorly understood. In this work, serological, histological, molecular biological, biochemical, and immunological methods were applied to explore the pathological significance and action of zinc finger protein 281 (ZFP281 in mouse, ZNF281 in human) and targeted strategies. We reported that ZFP281/ZNF281 abundance in hepatocytes was positively correlated with the progression of NASH. Hepatocyte-specific knockdown of Zfp281 prevented mice from NASH diet-induced liver injury, steatosis, inflammation, and fibrosis. Consistently, the metabolic syndromes in NASH mice, characterized by obesity, hyperglycemia, insulin resistance, and hyperlipidemia, were also relieved by hepatocyte-specific Zfp281 deficiency. Mechanistically, incremental ZNF281 led to the upregulation of proinflammatory signaling, receptor-interacting protein kinase 1 (RIPK1)/RIPK3/mixed lineage kinase domain like pseudokinase (MLKL) axis in hepatocytes bearing free fatty acid stress. Activated MLKL translocated to the mitochondrial membrane, disrupting mitochondrial fatty acid β-oxidation and facilitating lipid accumulation in hepatocytes exposed to free fatty acid stimulation; also, MLKL in activated form orientated to the plasma membrane, triggering the lytic death mode in hepatocytes and launching hepatocellular proinflammatory responses. Moreover, we screened a ZFP281 inhibitor, pterostilbene, and demonstrated that pterostilbene, by inhibiting ZFP281 elevation in NASH livers, reduced hepatocyte injury, steatosis, inflammatory responses and fibrogenesis. In conclusion, this work proposes that induction of ZFP281/ZNF281-RIPK1/RIPK3/MLKL signaling disrupts fatty acid metabolism, promoting lipid accumulation, and triggers proinflammatory cell death, accelerating hepatic necroinflammation. Our work identifies ZFP281/ZNF281 as a promising target as well as pterostilbene as a potential strategy for NASH managing.
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