BaCKgRoUND aND aIMS:In clinical and experimental NASH, the origin of the scar-forming myofibroblast is the HSC. We used foz/foz mice on a Western diet to characterize in detail the phenotypic changes of HSCs in a NASH model.
appRoaCH aND ReSUltS:We examined the singlecell expression profiles (scRNA sequencing) of HSCs purified from the normal livers of foz/foz mice on a chow diet, in NASH with fibrosis of foz/foz mice on a Western diet, and in livers during regression of NASH after switching back to a chow diet. Selected genes were analyzed using immunohistochemistry, quantitative real-time PCR, and short hairpin RNA knockdown in primary mouse HSCs. Our analysis of the normal liver identified two distinct clusters of quiescent HSCs that correspond to their acinar position of either pericentral vein or periportal vein. The NASH livers had four distinct HSC clusters, including one representing the classic fibrogenic myofibroblast. The three other HSC clusters consisted of a proliferating cluster, an intermediate activated cluster, and an immune and inflammatory cluster. The livers with NASH regression had one cluster of inactivated HSCs, which was similar to, but distinct from, the quiescent HSCs.
CoNClUSIoNS: Analysis of single-cell RNA sequencing in combination with an interrogation of previous studies revealed an unanticipated heterogeneity of HSC phenotypes under normal and injured states. (Hepatology 2021;74:667-685).C hronic liver injury of any etiology produces inflammation with the subsequent activation of mesenchymal cells to become myofibroblasts. In turn, myofibroblasts secrete the extracellular matrix (ECM), which produces the fibrous scar of liver fibrosis. (1,2) In experimental liver fibrosis including chronic carbon tetrachloride (CCl 4 ), chronic ethanol intake, and NASH, HSCs activate to become myofibroblasts. (3)(4)(5) Similarly, in human liver diseases, such as HBV, HCV, and NASH, the origin of myofibroblasts appears to be activated HSCs (aHSCs). (1,6,7) Other cell types such as mesothelial cells (important in capsular fibrosis), (8) portal fibroblasts (important in cholestatic fibrosis), (9) and fibrocytes (recruited to the inflamed liver) (10) make small contributions to hepatotoxic-induced liver fibrosis. Cell fate mapping in the injured and recovered liver has identified three distinct HSC phenotypes; the quiescent HSC (qHSC) in the normal liver, the aHSC in the fibrogenic liver, and the inactivated HSC (iHSC) in the liver with regression of fibrosis.