General Information of the Disease (ID: DIS00109)
Name
Nonalcoholic fatty liver disease
ICD
ICD-11: DB92
Full List of Target(s) of This Ferroptosis-centered Disease
Stearoyl-CoA desaturase (SCD)
In total 2 item(s) under this target
Experiment 1 Reporting the Ferroptosis-centered Disease Response by This Target [1]
Target for Ferroptosis Suppressor
Responsed Disease Non-alcoholic fatty liver disease [ICD-11: DB92]
Responsed Drug D-(-)-Fructose Investigative
Responsed Regulator Sterol regulatory element-binding protein 1 (SREBF1) Suppressor
Pathway Response Fatty acid metabolism hsa01212
Ferroptosis hsa04216
Glutathione metabolism hsa00480
Cell Process Cell ferroptosis
In Vitro Model hLCs (Liver cells)
In Vivo Model
Four-week-old male and female C57BL/6N mice were obtained from the Central Lab Animal Inc. (Seoul, South Korea) and housed in 42 x 27 x 15 cm polycarbonate cages (six mice per cage). The animals were assigned into either the control group (n = 12; six mice per sex) or fructose intervention group (n = 12; six mice per sex). After a week of acclimation, the fructose group was subjected to 34% fructose in deionized water (wt:vol) over six weeks to induce NAFLD conditions as previously described.11 To note, compared to conventional sugary beverages (e.g., soft drinks), the supplementation level of fructose is higher (11% vs. 34%) to induce liver damage markers within a reasonable intervention time range (i.e., 6 weeks).

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Response regulation The protein expressions of SREBP1 and its downstream targets ACC1, FASN and SCD1 were all increased in fructose-treated AML12 hepatocytes, which demonstrates fructose mediated upregulation of SREBP1. MiR-33-5p (miR-33) was identified as the key miRNA responsible for SREBP1 regulation upon fructose intake, which was validated by in vitro transfection assay. Collectively, fructose-induced oxidative damage induces ferroptosis, and miR-33 could be used as a serological biomarker of fructose-induced non-alcoholic fatty liver disease (NAFLD).
Experiment 2 Reporting the Ferroptosis-centered Disease Response by This Target [1]
Target for Ferroptosis Suppressor
Responsed Disease Non-alcoholic fatty liver disease [ICD-11: DB92]
Responsed Drug D-(-)-Fructose Investigative
Responsed Regulator mmu-miR-33-5p (miRNA) Driver
Pathway Response Fatty acid metabolism hsa01212
Ferroptosis hsa04216
Glutathione metabolism hsa00480
Cell Process Cell ferroptosis
In Vitro Model hLCs (Liver cells)
In Vivo Model
Four-week-old male and female C57BL/6N mice were obtained from the Central Lab Animal Inc. (Seoul, South Korea) and housed in 42 x 27 x 15 cm polycarbonate cages (six mice per cage). The animals were assigned into either the control group (n = 12; six mice per sex) or fructose intervention group (n = 12; six mice per sex). After a week of acclimation, the fructose group was subjected to 34% fructose in deionized water (wt:vol) over six weeks to induce NAFLD conditions as previously described.11 To note, compared to conventional sugary beverages (e.g., soft drinks), the supplementation level of fructose is higher (11% vs. 34%) to induce liver damage markers within a reasonable intervention time range (i.e., 6 weeks).

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Response regulation The protein expressions of SREBP1 and its downstream targets ACC1, FASN and SCD1 were all increased in fructose-treated AML12 hepatocytes, which demonstrates fructose mediated upregulation of SREBP1. MiR-33-5p (miR-33) was identified as the key miRNA responsible for SREBP1 regulation upon fructose intake, which was validated by in vitro transfection assay. Collectively, fructose-induced oxidative damage induces ferroptosis, and miR-33 could be used as a serological biomarker of fructose-induced non-alcoholic fatty liver disease (NAFLD).
Nuclear factor erythroid 2-related factor 2 (NFE2L2)
In total 2 item(s) under this target
Experiment 1 Reporting the Ferroptosis-centered Disease Response by This Target [2]
Target for Ferroptosis Marker/Suppressor
Responsed Disease Non-alcoholic fatty liver disease [ICD-11: DB92]
Responsed Drug Dehydroabietic acid Investigative
Responsed Regulator Kelch-like ECH-associated protein 1 (KEAP1) Driver
Pathway Response Fatty acid metabolism hsa01212
Ferroptosis hsa04216
Pathways in cancer hsa05200
Cell Process Cell ferroptosis
In Vitro Model HEK-293T cells Normal Homo sapiens CVCL_0063
L-02 cells Endocervical adenocarcinoma Homo sapiens CVCL_6926
In Vivo Model
The male C57BL/6J mice (6-8 weeks, Beijing Vital River Laboratory Animal Technology Co., Ltd., China) were exposed to 12 h of light and darkness at temperature (22 ± 2 ), humidity (55%) with free access to water and food. All the mice were acclimated for 1 week before the experiment, then the mice were fed normal chow diet (NCD) and high-fat diet (HFD, D12492) for 12 weeks. The HFD group was divided into 3 groups (HFD, low dose of DA (DA-L, 10 mg/kg/d), high dose of DA (DA-H, 20 mg/kg/d),n = 8)). DA was administered by gavage for 9 weeks, and 0.5% CMC-Na was administered by NCD and HFD.

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Response regulation Dehydroabietic acid (DA) inhibited ferroptosis and increased the expression of key genes such as ferroptosis suppressor protein 1 (FSP1) in vitro and vivo. In all, DA may bind with Keap1, activate Nrf2-ARE, induce its target gene expression, inhibit ROS accumulation and lipid peroxidation, and reduce HFD-induced nonalcoholic fatty liver disease (NAFLD).
Experiment 2 Reporting the Ferroptosis-centered Disease Response by This Target [8]
Target for Ferroptosis Marker/Suppressor
Responsed Disease Non-alcoholic fatty liver disease [ICD-11: DB92]
Responsed Drug Ginkgolide B Terminated
Pathway Response Fatty acid metabolism hsa01212
Ferroptosis hsa04216
Cell Process Cell ferroptosis
In Vitro Model Hep-G2 cells Hepatoblastoma Homo sapiens CVCL_0027
In Vivo Model
Male 8-week-old C57/BL6 ApoE-/-mice of weight (22~25 g) were purchased from Changzhou Cavens experimental animal Co., Ltd (Jiangsu, China). After 5 weeks of feeding, HFD-fed mice were randomly assigned into 4 groups (n = 10) : HFD group (0.9 % sodium chloride by gavage), GB-L group (at a high dose of 20 mg kg-1d-1 GB in 0.9 % sodium chloride by gavage), GB-H group (at a high dose of 30 mg kg-1d-1 GB in 0.9 % sodium chloride by gavage), and Ato group (1.3 mg kg-1d-1 Ato in 0.9 % sodium chloride by gavage) as a positive control. The mice in ND group were given the same volume of 0.9 % sodium chloride.

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Response regulation Ginkgolide B (GB), a main constituent of Ginkgo biloba extracts, reduces hepatic lipid accumulation and ameliorates nonalcoholic fatty liver disease (NAFLD) in obese mice. Remarkably, after Nrf2 interference, GB treatment significantly increased Nrf2 expression, indicating that GB exerted anti-ferroptosis effects by activation of Nrf2 pathway.
Long-chain-fatty-acid--CoA ligase 4 (ACSL4)
In total 3 item(s) under this target
Experiment 1 Reporting the Ferroptosis-centered Disease Response by This Target [3]
Target for Ferroptosis Driver
Responsed Disease Nonalcoholic steatohepatitis [ICD-11: DB92]
Responsed Drug Arsenic Investigative
Responsed Regulator Mitofusin-2 (MFN2) Driver
Pathway Response Fatty acid metabolism hsa01212
Cell Process Cell ferroptosis
In Vitro Model L-02 cells Endocervical adenocarcinoma Homo sapiens CVCL_6926
In Vivo Model
Adult male Sprague-Dawley rats (300 g-350 g, specific pathogen free) were obtained from Institute of Genome Engineered Animal Models for Human Disease of Dalian Medical University (Dalian, China). To explore the influence of NaAsO2 (CAS No.7784-46-5, Sigma-Aldrich, USA) on the liver, the rats were subjected to NaAsO2 at the dosage of 0, 2.5, and 5 mg/kg by gavage for 9 months. The control group was gavaged with distilled water as vehicle.

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Response regulation Arsenic induces rat liver nonalcoholic steatohepatitis (NASH) and Ferroptosis via interacting between Mitofusin-2 with IRE1. NaAsO2 increases IRE1 and Mfn2 expression, subsequently led to upregulated ACSL4 expression and 5-HETE via the directly combination Mfn2 with IRE1, ultimately induced ferroptotic cell death.
Experiment 2 Reporting the Ferroptosis-centered Disease Response by This Target [3]
Target for Ferroptosis Driver
Responsed Disease Nonalcoholic steatohepatitis [ICD-11: DB92]
Responsed Drug Sodium arsenite Investigative
Responsed Regulator Mitofusin-2 (MFN2) Driver
Pathway Response Fatty acid metabolism hsa01212
Cell Process Cell ferroptosis
In Vitro Model L-02 cells Endocervical adenocarcinoma Homo sapiens CVCL_6926
In Vivo Model
Adult male Sprague-Dawley rats (300 g-350 g, specific pathogen free) were obtained from Institute of Genome Engineered Animal Models for Human Disease of Dalian Medical University (Dalian, China). To explore the influence of NaAsO2 (CAS No.7784-46-5, Sigma-Aldrich, USA) on the liver, the rats were subjected to NaAsO2 at the dosage of 0, 2.5, and 5 mg/kg by gavage for 9 months. The control group was gavaged with distilled water as vehicle.

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Response regulation Arsenic induces rat liver nonalcoholic steatohepatitis (NASH) and Ferroptosis via interacting between Mitofusin-2 with IRE1. NaAsO2 increases IRE1 and Mfn2 expression, subsequently led to upregulated ACSL4 expression and 5-HETE via the directly combination Mfn2 with IRE1, ultimately induced ferroptotic cell death.
Experiment 3 Reporting the Ferroptosis-centered Disease Response by This Target [4]
Target for Ferroptosis Driver
Responsed Disease Non-alcoholic fatty liver disease [ICD-11: DB92]
Responsed Drug Epigallocatechin Gallate Investigative
Pathway Response Ferroptosis hsa04216
Cell Process Cell ferroptosis
In Vitro Model L-02 cells Endocervical adenocarcinoma Homo sapiens CVCL_6926
In Vivo Model
After adaptive feeding, mice were randomly assigned to five groups (n = 10 per group). The details of the groups are as follows: 1) the normal diet (ND) group in which mice were fed ND (18% calories from fat); 2) the HFD group in which mice were fed HFD (60% calories from fat); 3) the HFD-EGCG/L group in which mice received 20 mg/kgbw EGCG by oral gavage daily during HFD feeding; 4) the HFD-EGCG/H group in which mice received 100 mg/kgbw EGCG by oral gavage daily during HFD feeding; and 5) the HFD-Fer-1 group in which mice received intraperitoneal injection of Fer-1 at 1 mg/kg. bw every 3 days during HFD feeding. Mice in the EGCG treatment groups were supplemented with EGCG (20 and 100 mg/kgbw) for 12 weeks. Meanwhile, mice in the ND group and the HFD group were orally gavaged with deionized water daily.

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Response regulation Epigallocatechin-3-Gallate (EGCG) supplementation and Fer-1 treatment apparently increased the protein expression of GPX4 and markedly decreased the protein expression of COX-2 and ACSL4 in the livers of HFD-fed mice. Epigallocatechin gallate may exert protective effects on hepatic lipotoxicity by inhibiting mitochondrial reactive oxygen species-mediated hepatic ferroptosis. Findings from our study provide new insight into prevention and treatment strategies for non-alcoholic fatty liver disease pathological processes.
Prostaglandin G/H synthase 2 (PTGS2)
In total 1 item(s) under this target
Experiment 1 Reporting the Ferroptosis-centered Disease Response by This Target [4]
Target for Ferroptosis Driver
Responsed Disease Non-alcoholic fatty liver disease [ICD-11: DB92]
Responsed Drug Epigallocatechin Gallate Investigative
Pathway Response Ferroptosis hsa04216
Cell Process Cell ferroptosis
In Vitro Model L-02 cells Endocervical adenocarcinoma Homo sapiens CVCL_6926
In Vivo Model
After adaptive feeding, mice were randomly assigned to five groups (n = 10 per group). The details of the groups are as follows: 1) the normal diet (ND) group in which mice were fed ND (18% calories from fat); 2) the HFD group in which mice were fed HFD (60% calories from fat); 3) the HFD-EGCG/L group in which mice received 20 mg/kgbw EGCG by oral gavage daily during HFD feeding; 4) the HFD-EGCG/H group in which mice received 100 mg/kgbw EGCG by oral gavage daily during HFD feeding; and 5) the HFD-Fer-1 group in which mice received intraperitoneal injection of Fer-1 at 1 mg/kg. bw every 3 days during HFD feeding. Mice in the EGCG treatment groups were supplemented with EGCG (20 and 100 mg/kgbw) for 12 weeks. Meanwhile, mice in the ND group and the HFD group were orally gavaged with deionized water daily.

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Response regulation Epigallocatechin-3-Gallate (EGCG) supplementation and Fer-1 treatment apparently increased the protein expression of GPX4 and markedly decreased the protein expression of COX-2 and ACSL4 in the livers of HFD-fed mice. Epigallocatechin gallate may exert protective effects on hepatic lipotoxicity by inhibiting mitochondrial reactive oxygen species-mediated hepatic ferroptosis. Findings from our study provide new insight into prevention and treatment strategies for non-alcoholic fatty liver disease pathological processes.
Phospholipid hydroperoxide glutathione peroxidase (GPX4)
In total 5 item(s) under this target
Experiment 1 Reporting the Ferroptosis-centered Disease Response by This Target [4]
Target for Ferroptosis Suppressor
Responsed Disease Non-alcoholic fatty liver disease [ICD-11: DB92]
Responsed Drug Epigallocatechin Gallate Investigative
Pathway Response Ferroptosis hsa04216
Cell Process Cell ferroptosis
In Vitro Model L-02 cells Endocervical adenocarcinoma Homo sapiens CVCL_6926
In Vivo Model
After adaptive feeding, mice were randomly assigned to five groups (n = 10 per group). The details of the groups are as follows: 1) the normal diet (ND) group in which mice were fed ND (18% calories from fat); 2) the HFD group in which mice were fed HFD (60% calories from fat); 3) the HFD-EGCG/L group in which mice received 20 mg/kgbw EGCG by oral gavage daily during HFD feeding; 4) the HFD-EGCG/H group in which mice received 100 mg/kgbw EGCG by oral gavage daily during HFD feeding; and 5) the HFD-Fer-1 group in which mice received intraperitoneal injection of Fer-1 at 1 mg/kg. bw every 3 days during HFD feeding. Mice in the EGCG treatment groups were supplemented with EGCG (20 and 100 mg/kgbw) for 12 weeks. Meanwhile, mice in the ND group and the HFD group were orally gavaged with deionized water daily.

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Response regulation Epigallocatechin-3-Gallate (EGCG) supplementation and Fer-1 treatment apparently increased the protein expression of GPX4 and markedly decreased the protein expression of COX-2 and ACSL4 in the livers of HFD-fed mice. Epigallocatechin gallate may exert protective effects on hepatic lipotoxicity by inhibiting mitochondrial reactive oxygen species-mediated hepatic ferroptosis. Findings from our study provide new insight into prevention and treatment strategies for non-alcoholic fatty liver disease pathological processes.
Experiment 2 Reporting the Ferroptosis-centered Disease Response by This Target [5]
Target for Ferroptosis Marker/Suppressor
Responsed Disease Non-alcoholic fatty liver disease [ICD-11: DB92]
Responsed Regulator Beta-enolase (ENO3) Suppressor
Pathway Response Fatty acid metabolism hsa01212
Ferroptosis hsa04216
Cell Process Cell ferroptosis
In Vitro Model L-02 cells Endocervical adenocarcinoma Homo sapiens CVCL_6926
In Vivo Model
Eight-week-old C57BL/6 mice, body weight about 22-24 g, male (n = 24) were purchased from Beijing Vital River Laboratory Animal Technology Co. Ltd China. The mice were randomly divided into four groups and were maintained on a MCD diet (Medicience, Yangzhou, China) for 4, 8, and 12 weeks to induce NASH. Liver tissue and blood samples (from the eyeballs of the mice) were harvested for further analyses. Mice on a normal diet were used as the control.

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Response regulation ENO3 promoted the progression of NASH by negatively regulating ferroptosis via elevating GPX4 expression and lipid accumulation. These findings provided solid foundation for the mechanism of ferroptosis on the progression of NASH regulated by ENO3, suggesting that ENO3 may be a potential therapeutic target for non-alcoholic fatty liver disease.
Experiment 3 Reporting the Ferroptosis-centered Disease Response by This Target [6]
Target for Ferroptosis Suppressor
Responsed Disease Nonalcoholic steatohepatitis [ICD-11: DB92]
Responsed Regulator Delta(3,5)-Delta(2,4)-dienoyl-CoA isomerase, mitochondrial (ECH1) Suppressor
Pathway Response Fatty acid metabolism hsa01212
Ferroptosis hsa04216
Cell Process Cell ferroptosis
In Vitro Model hLCs (Liver cells)
HEK-293T cells Normal Homo sapiens CVCL_0063
In Vivo Model
Six-week-old male C57BL/6 mice were purchased from the Beijing Vital River Laboratory Animal Technology Co., Ltd. (Beijing, China). All of the mice were fed either a standard chow diet (SCD) (containing 62.2% carbohydrate, 24.6% protein, and 13.2% fat) or only a methionine-choline deficient diet (MCD) (containing 20% carbohydrate, 20% protein, and 60% fat) for 8 wk.

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Response regulation GPX4, a crucial regulator of ferroptosis, were upregulated in the livers of the ECH1-overexpressing mice. ECH1 knockdown exacerbated nonalcoholic steatohepatitis (NASH) progression, but this phenomenon was reversed through ferroptosis inhibition.
Experiment 4 Reporting the Ferroptosis-centered Disease Response by This Target [7]
Target for Ferroptosis Suppressor
Responsed Disease Non-alcoholic fatty liver disease [ICD-11: DB92]
Responsed Regulator Thymosin beta-4 (TMSB4X) Suppressor
Pathway Response Fatty acid metabolism hsa01212
Ferroptosis hsa04216
Apoptosis hsa04210
Cell Process Cell ferroptosis
Cell apoptosis
Cell proliferation
In Vitro Model L-02 cells Endocervical adenocarcinoma Homo sapiens CVCL_6926
In Vivo Model
The 42 Specified Pathogen Free (SPF)-grade Sprague Dawley (SD) male rats with weighing (180 ± 20) g were purchased from Changsha Tianqin Experimental Animal Center. All rat were randomly divided into seven groups (6 rat per group) using a random number table. Rats were deeply anesthetized with chloral hydrate (0.5 ml/kg) and killed at the end of the experiment, after 8 weeks of modeling and 4 weeks of drug treatment.

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Response regulation T4 ( TMSB4X and TMSB4Y) protects hepatocytes by inhibiting the GPX4-mediated ferroptosis pathway, which provides a new strategy and target for the treatment of non-alcoholic fatty liver disease (NAFLD).
Experiment 5 Reporting the Ferroptosis-centered Disease Response by This Target [7]
Target for Ferroptosis Suppressor
Responsed Disease Non-alcoholic fatty liver disease [ICD-11: DB92]
Responsed Regulator Thymosin beta-4, Y-chromosomal (TMSB4Y) Suppressor
Pathway Response Fatty acid metabolism hsa01212
Ferroptosis hsa04216
Apoptosis hsa04210
Cell Process Cell ferroptosis
Cell apoptosis
Cell proliferation
In Vitro Model L-02 cells Endocervical adenocarcinoma Homo sapiens CVCL_6926
In Vivo Model
The 42 Specified Pathogen Free (SPF)-grade Sprague Dawley (SD) male rats with weighing (180 ± 20) g were purchased from Changsha Tianqin Experimental Animal Center. All rat were randomly divided into seven groups (6 rat per group) using a random number table. Rats were deeply anesthetized with chloral hydrate (0.5 ml/kg) and killed at the end of the experiment, after 8 weeks of modeling and 4 weeks of drug treatment.

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Response regulation T4 (TMSB4X and TMSB4Y) protects hepatocytes by inhibiting the GPX4-mediated ferroptosis pathway, which provides a new strategy and target for the treatment of non-alcoholic fatty liver disease (NAFLD).
References
Ref 1 The role of microRNA-33 as a key regulator in hepatic lipogenesis signaling and a potential serological biomarker for NAFLD with excessive dietary fructose consumption in C57BL/6N mice. Food Funct. 2021 Jan 21;12(2):656-667. doi: 10.1039/d0fo02286a. Epub 2021 Jan 6.
Ref 2 Dehydroabietic acid improves nonalcoholic fatty liver disease through activating the Keap1/Nrf2-ARE signaling pathway to reduce ferroptosis. J Nat Med. 2021 Jun;75(3):540-552. doi: 10.1007/s11418-021-01491-4. Epub 2021 Feb 15.
Ref 3 Ferroptosis mediated by the interaction between Mfn2 and IRE promotes arsenic-induced nonalcoholic steatohepatitis. Environ Res. 2020 Sep;188:109824. doi: 10.1016/j.envres.2020.109824. Epub 2020 Jun 23.
Ref 4 Epigallocatechin gallate alleviates high-fat diet-induced hepatic lipotoxicity by targeting mitochondrial ROS-mediated ferroptosis. Front Pharmacol. 2023 Mar 21;14:1148814. doi: 10.3389/fphar.2023.1148814. eCollection 2023.
Ref 5 ENO3 promoted the progression of NASH by negatively regulating ferroptosis via elevation of GPX4 expression and lipid accumulation. Ann Transl Med. 2021 Apr;9(8):661. doi: 10.21037/atm-21-471.
Ref 6 Enoyl coenzyme A hydratase 1 alleviates nonalcoholic steatohepatitis in mice by suppressing hepatic ferroptosis. Am J Physiol Endocrinol Metab. 2021 May 1;320(5):E925-E937. doi: 10.1152/ajpendo.00614.2020. Epub 2021 Apr 5.
Ref 7 Thymosin beta 4 alleviates non-alcoholic fatty liver by inhibiting ferroptosis via up-regulation of GPX4. Eur J Pharmacol. 2021 Oct 5;908:174351. doi: 10.1016/j.ejphar.2021.174351. Epub 2021 Jul 16.
Ref 8 Study on the attenuated effect of Ginkgolide B on ferroptosis in high fat diet induced nonalcoholic fatty liver disease. Toxicology. 2020 Dec 1;445:152599. doi: 10.1016/j.tox.2020.152599. Epub 2020 Sep 22.