1. Bile acid sequestration reverses liver injury and prevents progression of nonalcoholic steatohepatitis in Western diet–fed mice
- Author
-
Takahashi, Shogo, Luo, Yuhuan, Ranjit, Suman, Xie, Cen, Libby, Andrew E, Orlicky, David J, Dvornikov, Alexander, Wang, Xiaoxin X, Myakala, Komuraiah, Jones, Bryce A, Bhasin, Kanchan, Wang, Dong, McManaman, James L, Krausz, Kristopher W, Gratton, Enrico, Ir, Diana, Robertson, Charles E, Frank, Daniel N, Gonzalez, Frank J, and Levi, Moshe
- Subjects
Digestive Diseases ,Chronic Liver Disease and Cirrhosis ,Prevention ,Liver Disease ,Hepatitis ,Nutrition ,5.1 Pharmaceuticals ,Aetiology ,2.1 Biological and endogenous factors ,Development of treatments and therapeutic interventions ,Oral and gastrointestinal ,Good Health and Well Being ,Animals ,Bile Acids and Salts ,Cecum ,Chemokine CCL2 ,Cholesterol ,Collagen Type I ,Collagen Type I ,alpha 1 Chain ,Diet ,Western ,Disease Models ,Animal ,Feces ,Gastrointestinal Microbiome ,Lactobacillus ,Lipid Metabolism ,Liver ,Male ,Mice ,Mice ,Inbred C57BL ,Non-alcoholic Fatty Liver Disease ,Sevelamer ,Severity of Illness Index ,Transforming Growth Factor beta ,liver injury ,liver metabolism ,bile acid ,metabolomics ,lipid metabolism ,bile acid sequestrants ,microbiome ,nonalcoholic fatty liver disease ,nonalcoholic steatohepatitis ,Chemical Sciences ,Biological Sciences ,Medical and Health Sciences ,Biochemistry & Molecular Biology - Abstract
Nonalcoholic fatty liver disease is a rapidly rising problem in the 21st century and is a leading cause of chronic liver disease that can lead to end-stage liver diseases, including cirrhosis and hepatocellular cancer. Despite this rising epidemic, no pharmacological treatment has yet been established to treat this disease. The rapidly increasing prevalence of nonalcoholic fatty liver disease and its aggressive form, nonalcoholic steatohepatitis (NASH), requires novel therapeutic approaches to prevent disease progression. Alterations in microbiome dynamics and dysbiosis play an important role in liver disease and may represent targetable pathways to treat liver disorders. Improving microbiome properties or restoring normal bile acid metabolism may prevent or slow the progression of liver diseases such as NASH. Importantly, aberrant systemic circulation of bile acids can greatly disrupt metabolic homeostasis. Bile acid sequestrants are orally administered polymers that bind bile acids in the intestine, forming nonabsorbable complexes. Bile acid sequestrants interrupt intestinal reabsorption of bile acids, decreasing their circulating levels. We determined that treatment with the bile acid sequestrant sevelamer reversed the liver injury and prevented the progression of NASH, including steatosis, inflammation, and fibrosis in a Western diet-induced NASH mouse model. Metabolomics and microbiome analysis revealed that this beneficial effect is associated with changes in the microbiota population and bile acid composition, including reversing microbiota complexity in cecum by increasing Lactobacillus and decreased Desulfovibrio The net effect of these changes was improvement in liver function and markers of liver injury and the positive effects of reversal of insulin resistance.
- Published
- 2020