1. C-Reactive Protein Protects Against Acetaminophen-Induced Liver Injury by Preventing Complement Overactivation
- Author
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Zhe Wang, Bin Cheng, Jian-Min Lv, Shang-Rong Ji, Xiao-Ling Liu, Hai-Yun Li, Zhao-Ming Tang, Yi Wu, Yu-Lin Liang, and Ning Gao
- Subjects
Inflammation ,RC799-869 ,Pharmacology ,Mice ,Animals ,Medicine ,Receptor ,Acetaminophen ,Liver injury ,Hepatology ,biology ,business.industry ,C-reactive protein ,Pattern Recognition Receptor ,Gastroenterology ,Pattern recognition receptor ,Biomarker ,Diseases of the digestive system. Gastroenterology ,medicine.disease ,Rats ,Mice, Inbred C57BL ,C-Reactive Protein ,Editorial ,Chemical and Drug Induced Liver Injury, Chronic ,Knockout mouse ,Hepatocytes ,biology.protein ,Biomarker (medicine) ,Chemical and Drug Induced Liver Injury ,medicine.symptom ,business ,medicine.drug - Abstract
Background and aims C-reactive protein (CRP) is a hepatocyte-produced marker of inflammation yet with undefined function in liver injury. We aimed to examine the role of CRP in acetaminophen-induced liver injury (AILI). Methods The effects of CRP in AILI were investigated using CRP knockout mice and rats combined with human CRP rescue. The mechanisms of CRP action were investigated in vitro and in mice with Fcγ receptor 2B knockout, C3 knockout, or hepatic expression of CRP mutants defective in complement interaction. The therapeutic potential of CRP was investigated by intraperitoneal administration at 2 or 6 hours post–AILI induction in wild-type mice. Results CRP knockout exacerbated AILI in mice and rats, which could be rescued by genetic knock-in, adeno-associated virus–mediated hepatic expression or direct administration of human CRP. Mechanistically, CRP does not act via its cellular receptor Fcγ receptor 2B to inhibit the early phase injury to hepatocytes induced by acetaminophen; instead, CRP acts via factor H to inhibit complement overactivation on already injured hepatocytes, thereby suppressing the late phase amplification of inflammation likely mediated by C3a-dependent actions of neutrophils. Importantly, CRP treatment effectively alleviated AILI with a significantly extended therapeutic time window than that of N-acetyl cysteine. Conclusion Our results thus identify CRP as a crucial checkpoint that limits destructive activation of complement in acute liver injury, and we argue that long-term suppression of CRP expression or function might increase the susceptibility to AILI.
- Published
- 2022
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