Laparoscopic Sleeve Gastrectomy Improves Nonalcoholic Fatty Liver Disease–Related Liver Damage in Adolescents by Reshaping Cellular Interactions and Hepatic Adipocytokine Production - 23/02/18
, Guido Carpino, MD, PhD 3, *, Francesco De Peppo, MD 4, Romina Caccamo, MD 4, Antonella Mosca, MD 1, Ilaria Romito, PhD 5, Diletta Overi, MD 6, Antonio Franchitto, MSc 6, Paolo Onori, MD 6, Anna Alisi, PhD 5, Eugenio Gaudio, MD 6Abstract |
Objectives |
To investigate whether the modulation of local cellular cross-talks and the modification of hepatic adipocytokine expression could mechanistically explain the improvement of liver histopathology after laparoscopic sleeve gastrectomy (LSG) in adolescents with nonalcoholic fatty liver disease (NAFLD).
Study design |
Twenty obese (body mass index of ≥35 kg/m2) adolescents who underwent LSG and with biopsy-proven NAFLD were included. At baseline (T0) and 1 year after treatment, patients underwent clinical evaluation, blood tests, and liver biopsy. Hepatic progenitor cells, hepatic stellate cells (HSCs), macrophages, and adipocytokines were evaluated by immunohistochemistry and immunofluorescence.
Results |
Liver biopsy samples after LSG demonstrated a significant improvement of NAFLD Activity Score and fibrosis. Immunohistochemistry indicated a significant reduction of hepatocyte cell cycle arrest, ductular reaction, activated HSC, and macrophage number after LSG compared with T0. The activation state of HSC was accompanied by modification in the expression of the autophagy marker LC3. Hepatocyte expression of adiponectin was significant higher after LSG than into T0. Moreover, LSG caused decreased resistin expression in Sox9+ hepatic progenitor cells compared with T0. The number of S100A9+ macrophages was also reduced by LSG correlating with resistin expression. Finally, serum levels of proinflammatory cytokines significantly correlated with macrophages and activated HSC numbers.
Conclusions |
The histologic improvement induced by LSG is associated with the reduced activation of local cellular compartments (hepatic progenitor cells, HSCs, and macrophages), thus, strengthening the role of cellular interactions and hepatic adipocytokine production in the pathogenesis of NAFLD.
Le texte complet de cet article est disponible en PDF.Keywords : hepatic progenitor cells, bariatric surgery, ductular reaction, adiponectin, resistin
Abbreviations : BMI, DR, HPC, HSC, IH, IHC, IL, LSG, NAFLD, NAS, NASH, T0, T1, TNF, α-SMA
Plan
| E.G. was supported by a research project grant from Sapienza University of Rome (RBAP10Z7FS_001) and by PRIN (2009X84L84_001). V.N. and A.A. are supported by the Italian Ministry of Health funds (Fondi Ricerca Corrente 2014-2016). The authors declare no conflicts of interest. |
Vol 194
P. 100 - mars 2018 Retour au numéro
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