Non-alcoholic fatty liver disease (NAFLD) refers to a spectrum of disease states in which the liver undergoes profound changes ranging from non-symptomatic simple steatosis (build-up of fat in the liver) to the more end stages of the disease including non-alcoholic steatohepatitis (NASH) and hepatocellular carcinoma (HCC). With the ongoing obesity epidemic, NAFLD has a global prevalence of 25% and approximately a fifth of those patients will progress to NASH. For these last disease stages there are currently no treatment options other than liver transplant.
During early stages of NAFLD a change in lifestyle and weight loss can alleviate symptoms in patients. However, it remains unclear to what degree the liver can fully recover. Recent work pioneered the idea that tissue develops a ‘memory’ of previous inflammatory events. If so, patients recovered from NAFLD following weight loss might also carry such a memory in their liver with potentially long-lasting effects. This memory can be carried by individual long-lived cells in the form of changed to the DNA structure (so called epigenetic changes). In the liver the various structural cells (hepatocytes, stellate cells and endothelial cells) are closely interlinked with a specific population of immune cells, the macrophages. Macrophages are found in all tissues and perform unique functions that are essential to maintain homeostasis in their respective organ. In the liver a large population of long-lived macrophages exists referred to as Kupffer cells (KCs). As these various cells in the liver form a close-knit circuit a ‘memory ‘in one population has the capacity to alter the complete liver circuitry. During NAFLD all the cells in the liver are heavily affected and could potentially carry such a memory. Hence the overall objective of this project is to investigate to what degree the various cells in the liver carry a memory following recovery of NAFLD.