1.TM6SF2 E167K variant decreases PNPLA3-mediated PUFA transfer to promote hepatic steatosis and injury in MASLD
Baokai SUN ; Xiaoqian DING ; Jie TAN ; Jie ZHANG ; Xueru CHU ; Shuimi ZHANG ; Shousheng LIU ; Zhenzhen ZHAO ; Shiying XUAN ; Yongning XIN ; Likun ZHUANG
Clinical and Molecular Hepatology 2024;30(4):863-882
		                        		
		                        			 Background:
		                        			s/Aims: Transmembrane 6 superfamily member 2 (TM6SF2) E167K variant is closely associated with the occurrence and development of metabolic dysfunction-associated steatotic liver disease (MASLD). However, the role and mechanism of TM6SF2 E167K variant during MASLD progression are not yet fully understood. 
		                        		
		                        			Methods:
		                        			The Tm6sf2167K knock-in (KI) mice were subjected to high-fat diet (HFD). Hepatic lipid levels of Tm6sf2167K KI mice were detected by lipidomics analysis. Thin-layer chromatography (TLC) was used to measure the newly synthesized triglyceride (TG) and phosphatidylcholine (PC). 
		                        		
		                        			Results:
		                        			The TM6SF2 E167K variant significantly aggravated hepatic steatosis and injury in HFD-induced mice. Decreased polyunsaturated PC level and increased polyunsaturated TG level were found in liver tissue of HFDinduced Tm6sf2167K KI mice. Mechanistic studies demonstrated that the TM6SF2 E167K variant increased the interaction between TM6SF2 and PNPLA3, and impaired PNPLA3-mediated transfer of polyunsaturated fatty acids (PUFAs) from TG to PC. The TM6SF2 E167K variant increased the level of fatty acid-induced malondialdehyde and reactive oxygen species, and decreased fatty acid-downregulated cell membrane fluidity. Additionally, the TM6SF2 E167K variant decreased the level of hepatic PC containing C18:3, and dietary supplementation of PC containing C18:3 significantly attenuated the TM6SF2 E167K-induced hepatic steatosis and injury in HFD-fed mice. 
		                        		
		                        			Conclusions
		                        			The TM6SF2 E167K variant could promote its interaction with PNPLA3 and inhibit PNPLA3-mediated transfer of PUFAs from TG to PC, resulting in the hepatic steatosis and injury during MASLD progression. PC containing C18:3 could act as a potential therapeutic supplement for MASLD patients carrying the TM6SF2 E167K variant. 
		                        		
		                        		
		                        		
		                        	
2.Role of heat shock protein 90 in hepatitis B virus replication
Yin HUA ; Haili FANG ; Shousheng LIU ; Yongning XIN ; Mei ZHANG ; Shiying XUAN
Journal of Clinical Hepatology 2023;39(10):2443-2447
		                        		
		                        			
		                        			Hepatitis B virus (HBV) has the characteristics of wide transmission, a high chronic infection rate, and a low cure rate, and improving the cure rate of HBV may help to improve the long-term prognosis of patients. Heat shock protein 90 (Hsp90) is a chaperone protein widely present in organisms. In recent years, more and more studies have shown that Hsp90 is associated with HBV infection and plays an important role in HBV replication. It can not only interact with specific proteins of the virus to promote its replication, but also interact with the host’s own proteins to perform its function. This article reviews the role of Hsp90 in HBV replication in recent studies, so as to provide new theoretical guidance and directions for the development of new anti-HBV drugs targeting Hsp90 and the prevention and treatment of HBV infection in the future. 
		                        		
		                        		
		                        		
		                        	
3.Association between intrahepatic bile duct alterations and liver fibrosis
Wenzheng YOU ; Wanlei REN ; Shiying XUAN ; Doudou HU
Journal of Clinical Hepatology 2022;38(1):187-190
		                        		
		                        			
		                        			 Liver cirrhosis is a liver disease caused by various factors and is characterized by diffuse fibrous hyperplasia, lobular structural damage, and pseudolobule formation. Bile duct proliferation has been observed in a variety of animal models of liver cirrhosis and patients with liver cirrhosis caused by different etiologies, and it is regulated by signaling pathways with the involvement of multiple regulatory factors such as neuropeptides, neurotransmitters, and hormones. Moreover, the proliferated bile ducts promote the formation of liver fibrosis by mediating the proliferation and activation of hepatic stellate cells. This article summarizes the changes of the intrahepatic bile duct system in liver cirrhosis and its influence on the process of liver fibrosis, various signaling pathways associated with cholangiocyte proliferation and liver fibrosis, and the value of the dynamic evolution of bile duct structure in predicting the degree of liver fibrosis. It is pointed out that bile duct proliferation may become a potential target for the intervention of liver fibrosis, which provides new ideas and methods for early treatment and reversal of liver fibrosis. 
		                        		
		                        		
		                        		
		                        	
4.AGT rs5051 gene polymorphism increases the risk of coronary heart disease in patients with non-alcoholic fatty liver disease in the Han Chinese population
Mengzhen DONG ; Zhonghua LIN ; Shousheng LIU ; Yongning XIN ; Shiying XUAN
Chinese Journal of Hepatology 2021;29(11):1095-1100
		                        		
		                        			
		                        			Objective:To investigate the relationship between the angiotensinogen (AGT) rs5051 single nucleotide polymorphism (SNP) and the onset risk of coronary heart disease (CHD) in patients with non-alcoholic fatty liver disease (NAFLD) in the Han Chinese population.Methods:A total of 454 subjects were enrolled in this study. Among them, 140 cases were with NAFLD, 112 cases with NAFLD combined with CHD, and 202 healthy controls. Blood samples of all subjects were examined for biochemical indexes. Genotype at AGT rs5051 locus was detected by polymerase chain reaction. SPSS 21.0 statistical software was used for data statistical analysis.Results:The differences in distribution of AGT rs5051 genotypes and alleles between the NAFLD and the control group were not statistically significant ( P > 0.05). The differences in the distribution of AGT rs5051 genotypes and alleles between the NAFLD combined with CHD and the NAFLD group were statistically significant ( χ2 = 10.32, P = 0.001; χ2 = 11.72, P < 0.001). Binary logistic regression analysis results showed that TC + CC genotype had increased the occurrence risk of CHD in NAFLD patients ( OR = 2.203, 95% CI: 1.322 ~ 3.670, P = 0.02) than AGT rs5051 TT genotype carriers. After adjusting for gender, age, and body mass index, the TC + CC genotype still significantly increased the occurrence risk of CHD in NAFLD patients ( OR = 2.378, 95% CI: 1.384 ~ 4.087, P = 0.02). In addition, AGT rs5051 C allele mutations had significantly increased the occurrence risk of CHD in patients with NAFLD ( OR = 2.018 before adjustment, 95% CI: 1.345 ~ 3.027, P = 0.001; OR = 2.161, 95% CI: 1.406 ~ 3.322 after adjustment. P < 0.001). Conclusion:This study is the first to report the correlation between AGT rs5051 polymorphism and the occurrence risk of CHD in patients with NAFLD in Han Chinese population. AGT rs5051 polymorphism can significantly increase the risk of CHD in patients with NAFLD.
		                        		
		                        		
		                        		
		                        	
5.Construction of transmembrane 6 superfamily member 2 E167K gene knock-in mouse model by using CRISPR/Cas9 technology
Baokai SUN ; Shousheng LIU ; Jie ZHANG ; Shiying XUAN ; Yongning XIN
Chinese Journal of Hepatology 2020;28(7):591-596
		                        		
		                        			
		                        			Objective:To construct a transmembrane 6 superfamily member 2 (Tm6sf2) E167K gene knock-in mouse model.Methods:The plasmid was constructed to simultaneously express the single-stranded guide RNA Cas9 at a specific site of the mouse Tm6sf2 gene in the donor plasmid carrying the Tm6sf2 E167K fragment. The above two plasmids were injected into the mouse fertilized eggs together. The positive F0 generation mice were validated by PCR detection and sequencing. The number of F2 generation surviving mice in three genotypes of wild (Wt), heterozygous and knock-in (KI) were calculated. Wt and KI male mice (8 mice/ group) of F2 generation littermates were selected and given a normal diet for 8 weeks. The body weight of the mice was recorded every week, and the glucose metabolism and lipid metabolism indexes of the two mice were detected. The comparison between groups was performed with an independent sample t-test.Results:Genotype detection and sequencing results showed that the Tm6sf2 E167K gene knock-in mouse model was successfully established. KI mice had absence of homozygous lethal embryo phenotype. The body weight of KI mice was higher than that of Wt mice during lactation, and the difference between the two groups was statistically significant ( P < 0.05).The fasting blood glucose of KI mice (9.50 ± 0.33)mmol/L was higher than that of Wt mice (7.80 ± 0.30)mmol/L, and the difference between the two groups was statistically significant ( P < 0.05). During the oral glucose tolerance test, the 2-hour blood glucose level of KI mice (9.20 ± 0.51)mmol/L was higher than that of Wt mice (7.60 ± 0.18)mmol/L, and the difference between the two groups was statistically significant ( P < 0.05). The liver triglyceride content of KI mice (8.40 ± 0.55)mg/g was higher than that of Wt mice (7.30 ± 0.63)mg/g, but the difference was not statistically significant ( P > 0.05). There was no significant difference in plasma triglyceride levels between the two mice ( P > 0.05). The Oil red O staining results showed that KI mice had more lipid accumulation in the centrilobular region of ??liver than Wt mice. Conclusion:Tm6sf2 E167K gene knock-in mice were successfully constructed. Tm6sf2 E167K gene knock-in can cause abnormal glucose metabolism in mice and promote the occurrence of hepatic steatosis.
		                        		
		                        		
		                        		
		                        	
6.Research progress of single-nucleotide polymorphism in theTM6SF2 rs58542926
Yuan LI ; Xin SUN ; Shuhui ZHAN ; Yuqiang GAO ; Yongning XIN ; Shiying XUAN
Chinese Journal of Hepatology 2019;27(3):223-226
		                        		
		                        			
		                        			Transmembrane 6 superfamily member 2 (TM6SF2) is a recently discovered gene,which is located on the chromosome 19 (19p12) and encodes a protein consisting of 351 amino acids.Presently,many studies have reported that the single-nucleotide polymorphism of TM6SF2 rs58542926 and plasma lipids are closely related to the incidence and development of diseases,such as non-alcoholic fatty liver disease (NAFLD),cardiovascular disease (CVD),liver cancer,and hepatitis C.This review will summarize the research progress conducted in these areas.
		                        		
		                        		
		                        		
		                        	
7.Clinical features of cholestatic liver disease of 107 cases
Xin XU ; Yichen DAI ; Shiying XUAN
Journal of Clinical Hepatology 2018;34(11):2364-2367
		                        		
		                        			
		                        			 ObjectiveTo investigate the clinical features of cholestatic liver disease (CLD), and to provide a reference for strengthening the diagnosis and treatment of this disease. MethodsA retrospective analysis was performed for the clinical data of 107 patients who were admitted to Chenggong Hospital Affiliated to Xiamen University from January 2015 to December 2017 and were diagnosed with CLD. The t-test was used for comparison of continuous data between groups. ResultsMost patients had the clinical symptoms of weakness, loss of appetite, nausea, abdominal distension, pruritus, and jaundice. According to the site of cholestasis, there were 64 patients (59.8%) with intrahepatic cholestasis and 43 (40.2%) with extrahepatic cholestasis. The cause of the disease was common bile duct stones in 21 patients (19.6%), bile duct parasites in 1 patient (0.9%), primary sclerosing cholangitis in 2 patients (1.9%), primary biliary cirrhosis in 3 patients (2.8%), liver cancer in 8 patients (7.5%), bile duct carcinoma in 5 patients (4.7%), pancreatic cancer in 4 patients (3.7%), pancreatitis in 12 patients (11.2%), viral hepatitis in 28 patients (26.2%), drug-induced liver injury in 11 patients (10.3%), alcoholic hepatitis in 6 patients (5.6%), nonalcoholic fatty liver disease in 4 patients (3.7%), and autoimmune hepatitis in 2 patients (19%). The CLD patients with underlying diseases had a significantly poorer liver function (alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, alkaline phosphatase, bile acid, and total bilirubin) than those with CLD alone (t=-3.44, -2.99, -2.42, -4.39, -3.34, and -2.49, all P<0.05). Most of the patients achieved good recovery after liver-protecting, transaminase-lowering, and jaundice clearance treatment. The patients with tumors had poor prognosis. ConclusionCLD has various causes, and its clinical features lack specificity. Clinicians should pay enough attention to this disease. 
		                        		
		                        		
		                        		
		                        	
8.RBP2 induces stem-like cancer cells by promoting EMT and is a prognostic marker for renal cell carcinoma.
Dahai ZHOU ; Vinodh KANNAPPAN ; Xiang CHEN ; Jingqin LI ; Xuefeng LENG ; Jinping ZHANG ; Shiying XUAN
Experimental & Molecular Medicine 2016;48(6):e238-
		                        		
		                        			
		                        			Renal cell carcinoma (RCC), one of the most common kidney cancers, has a poor prognosis. Epithelial to mesenchymal transition (EMT) is a hallmark of carcinoma invasion and metastasis. Several studies have examined the molecular regulation of EMT, but the relationship between histone demethylases and EMT is little understood. In this study, we investigated the role of retinoblastoma-binding protein-2 (RBP2), a histone demethylase that is highly expressed in RCC and is positively correlated with poor RCC prognosis in the regulation of EMT. We found that ectopic overexpression of RBP2 can induce cancer stem cell-like (CSC) phenotypes through EMT in RCC cells by converting them to a more mesenchymal phenotype. This results in increased resistance to apoptosis, which leads to enhanced tumor growth in xenograft models. Together, our data show that RBP2 is an epigenetic regulator that has an important role in the initiation of CSC phenotypes through EMT, leading to tumor progression. RBP2 is also a novel biomolecule for RCC diagnosis, and prognosis and may be a therapeutic target.
		                        		
		                        		
		                        		
		                        			Apoptosis
		                        			;
		                        		
		                        			Carcinoma, Renal Cell*
		                        			;
		                        		
		                        			Diagnosis
		                        			;
		                        		
		                        			Epigenomics
		                        			;
		                        		
		                        			Heterografts
		                        			;
		                        		
		                        			Histone Demethylases
		                        			;
		                        		
		                        			Histones
		                        			;
		                        		
		                        			Kidney Neoplasms
		                        			;
		                        		
		                        			Neoplasm Metastasis
		                        			;
		                        		
		                        			Phenotype
		                        			;
		                        		
		                        			Prognosis
		                        			
		                        		
		                        	
9.Role and mechanism of action of fibroblast growth factor-21 in reducing triglyceride in nonalcoholic fatty liver disease.
Lizhen CHEN ; Man JIANG ; Yongning XIN ; Jian WANG ; Yang LIU ; Xiangjun JIANG ; Shiying XUAN
Chinese Journal of Hepatology 2016;24(2):102-107
OBJECTIVETo investigate the role and mechanism of action of fibroblast growth factor-21 (FGF-21) in reducing triglyceride (TG) in the in vitro and in vivo models of nonalcoholic fatty liver disease (NAFLD).
METHODS(1) A mixture of free fatty acids was used to establish a model of steatosis in L02 cells, and the cells were treated with various concentrations of FGF-21 or fenofibrate. Twenty-four hours later, oil red O staining was performed to observe the degree of steatosis, and intracellular TG content was determined. RT-PCR and Western blot were applied to measure the mRNA and protein expression of sterol regulatory element-binding protein-1c (SREBP-1c). (2) High-fat diet was used to establish a mouse model of steatosis, and these mice were intraperitoneally injected with FGF-21 or fenofibrate. Eight weeks later, whole blood and liver samples were collected, and HE staining was performed to observe steatosis. Meanwhile, the serum levels of TG, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) were measured, and TG content in the liver was also measured. One-way analysis of variance was used for comparison of data between multiple groups, and the least significant difference t-test was used for comparison between any two groups.
RESULTS(1) Compared with the control group, the model group showed significant steatosis, with significant increases in intracellular lipid droplets and TG content (t = -20.57, P < 0.01), while FGF-21 reduced the number of intracellular lipid droplets and TG content (F = 98.16, P < 0.01) in a dose-dependent manner. In addition, the model group had significantly increased mRNA and protein expression of SREBP-1c compared with the control group (t = -10.73 and -0.1006, both P < 0.01), while FGF-21 down-regulated the mRNA and protein expression of SREBP-1c (F = 161.35 and 36.72, both P < 0.01). (2) Compared with the mice in the control group, those in the model group showed significant steatosis and had significant increases in serum TG level and TG content in the liver (t = -18.84 and 15.71, both P < 0.01). FGF-21 relieved hepatic steatosis and reduced the serum TG level and TG content in the liver (t = 18.11 and 9.46, both P < 0.01). Moreover, FGF-21 reduced the serum levels of ALT and AST in NAFLD mice (t = 25.93 and 12.50, both P < 0.01).
CONCLUSIONFGF-21 can inhibit the synthesis of TG through suppressing the expression of SREBP-1c, which further confirms the potential therapeutic effect of FGF-21 in the treatment of NAFLD. This may provide new ideas for the treatment of NAFLD.
Alanine Transaminase ; blood ; Animals ; Aspartate Aminotransferases ; blood ; Cell Line ; Diet, High-Fat ; Disease Models, Animal ; Fenofibrate ; pharmacology ; Fibroblast Growth Factors ; pharmacology ; Mice ; Non-alcoholic Fatty Liver Disease ; blood ; drug therapy ; Sterol Regulatory Element Binding Protein 1 ; metabolism ; Triglycerides ; blood
10.Research advances in susceptibility genes and their role in the pathogenesis of nonalcoholic fatty liver disease
Shiying XUAN ; Chen YUAN ; Linlin LU
Journal of Clinical Hepatology 2016;32(3):446-452
		                        		
		                        			
		                        			 Currently the incidence of nonalcoholic fatty liver disease (NAFLD) is increasing, and the age of onset is getting younger worldwide, resulting in a heavy economic burden for both individuals and the society. Since NAFLD is closely related to heredity, metabolism, and the environment, genetic factors play an important role in the development and progression of NAFLD. With the development and wide application of the techniques from the genome-wide association studies, new research advances have been achieved in the susceptibility genes of NAFLD. This review summarizes the related research findings at home and abroad, and investigates the pathogenic factors for NAFLD and related mechanisms with a focus on the polymorphisms of susceptibility genes. 
		                        		
		                        		
		                        		
		                        	
            
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