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临床试验/NCT06913699
NCT06913699进行中(未招募)不适用

The Ameliorative Effect of C-Kit (+) Hepatic Endothelial Cells With Mertk Deficiency on Nonalcoholic Steatohepatitis

Shanghai East Hospital1 个研究点 分布在 1 个国家目标入组 6 人开始时间: 2024年4月1日最近更新:

试验速览

阶段
不适用
状态
进行中(未招募)
发起方
入组人数
6
试验地点
1
主要终点
Mertk expression levels of liver tissues

研究概览

简要总结

The prevalence of non-alcoholic fatty liver disease (NAFLD) has been steadily increasing, with 10-20% of affected individuals progressing to non-alcoholic steatohepatitis (NASH). NASH is pathologically characterized by hepatic inflammation, steatosis, and hepatocyte injury. Furthermore, this condition carries a significant risk of progression to advanced hepatic fibrosis (pathological Scheuer fibrosis stage F≥3), cirrhosis, and even hepatocellular carcinoma (HCC). In recent years, NASH has emerged as the leading contributor to the growing burden of cirrhosis worldwide, representing a major public health challenge. Despite the high incidence and clinical severity of NAFLD, there are currently no FDA-approved therapeutic agents for its management. Therefore, elucidating the molecular mechanisms underlying NAFLD-associated NASH progression is critical for developing targeted pharmacological interventions capable of preventing, ameliorating, or potentially reversing disease progression.

详细描述

I. Study Background Non-alcoholic fatty liver disease (NAFLD) has become one of the most prevalent liver disorders globally. Despite its high incidence and severity, no effective therapeutic agents currently exist. Existing treatments focus on symptomatic relief, such as hepatoprotection and enzyme reduction, rather than addressing the underlying pathogenesis. Therefore, elucidating the mechanisms driving the progression of NAFLD-related non-alcoholic steatohepatitis (NASH) and hepatic fibrosis is critical for developing preventive, ameliorative, or even curative strategies, holding significant strategic importance.

  1. Role of LSECs in NAFLD Pathogenesis:

Liver sinusoidal endothelial cells (LSECs), the primary components of the hepatic sinusoidal endothelium, form a physical barrier regulating substance exchange between the hepatic parenchyma and circulation. As highly specialized endothelial cells (ECs) and the most abundant non-parenchymal cells (NPCs) in the liver, LSECs play pivotal roles in hepatic pathophysiology. Targeting LSEC function represents a promising approach to mitigate NAFLD progression and complications. 2. Heterogeneous Transcriptomic Features of LSEC Subpopulations in NAFLD:

Single-cell RNA sequencing (scRNA-seq) enables genome-wide amplification and sequencing at the single-cell level. In the liver, hepatocytes (HCs) and NPCs exhibit marked transcriptomic heterogeneity, underpinning metabolic and functional zonation. This highlights the potential of single-cell analysis in understanding liver diseases. However, scRNA-seq studies on LSECs in NAFLD remain unexplored. 3. Hypothesis: C-Kit(+)/Gas6(-)-LSEC Subpopulation Exacerbates NAFLD via Gas6/Mertk-Mediated Regulation of PINK1 Mitophagy:

Bone marrow-derived endothelial progenitor cells (EPCs), marked by C-Kit (CD117), may express C-Kit in ECs under pathological conditions. Gas6, a ligand for TAM receptors (Tyro3, Axl, Mertk), activates downstream signaling cascades regulating cell migration, inflammation, survival, and mitophagy. In NAFLD, Gas6/Mertk exhibits cell-specific roles : Anti-inflammatory in hepatic macrophages; Pro-fibrotic in hepatic stellate cells (HSCs); Protective in hepatocytes (HCs). However, the role of Gas6/Mertk in LSECs during NAFLD remains unknown. Mitochondrial dysfunction is a hallmark of NAFLD, and impaired mitophagy (e.g., PINK1 deficiency) exacerbates hepatic inflammation, steatosis, and fibrosis. Emerging evidence suggests Gas6/Mertk enhances mitophagy to preserve mitochondrial function. For instance, Mertk-/- mice exhibit cardiomyocyte mitochondrial dysfunction, and Gas6 promotes mitophagy.

研究设计

研究类型
Observational
观察模型
Cohort
时间视角
Cross Sectional

入排标准

年龄范围
18 Years 至 65 Years(Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • Clinical diagnosis of Non-Alcoholic Fatty Liver Disease
  • Age 18-65 years

排除标准

  • Cirrhosis (compensated or decompensated)
  • Hepatocellular carcinoma
  • Active viral hepatitis (HBV, HCV)
  • Primary biliary cholangitis
  • Primary sclerosing cholangitis
  • Recent history of illicit drug use
  • Alcohol intake≥20 g/day for women and ≥30 g/day for men
  • Current pregnancy or breastfeeding
  • Severe comorbidities.

结局指标

主要结局

Mertk expression levels of liver tissues

时间窗: From enrollment to the end of treatment at 4 weeks

1. Liver Biopsy and Tissue Collection: Ultrasound-guided liver biopsy in 6 NAFLD patients. Histopathological evaluation (HE, Masson staining) for NASH and fibrosis (NAS and Scheuer scoring). Clinical data collection and liver tissue storage (-80°C). 2. Expression Analysis of Mertk: Immunofluorescence staining of liver tissues. 3. Statistical Analysis: Compare Mertk expression levels between mild and severe NAFLD patients.

C-Kit expression levels of liver tissues

时间窗: From enrollment to the end of treatment at 4 weeks

1. Liver Biopsy and Tissue Collection: Ultrasound-guided liver biopsy in 6 NAFLD patients. Histopathological evaluation (HE, Masson staining) for NASH and fibrosis (NAS and Scheuer scoring). Clinical data collection and liver tissue storage (-80°C). 2. Expression Analysis of C-Kit: Immunofluorescence staining of liver tissues. 3. Statistical Analysis: Compare C-Kit expression levels between mild and severe NAFLD patients.

次要结局

未报告次要终点

研究者

发起方
Shanghai East Hospital
申办方类型
Other
责任方
Sponsor

研究点 (1)

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