NKG2D-mediated detection of metabolically stressed hepatocytes by innate-like T cells is essential for initiation of NASH and fibrosis

Sci Immunol. 2023 Sep 29;8(87):eadd1599. doi: 10.1126/sciimmunol.add1599. Epub 2023 Sep 29.

Abstract

Metabolic-associated fatty liver disease (MAFLD) is a spectrum of clinical manifestations ranging from benign steatosis to cirrhosis. A key event in the pathophysiology of MAFLD is the development of nonalcoholic steatohepatitis (NASH), which can potentially lead to fibrosis and hepatocellular carcinoma, but the triggers of MAFLD-associated inflammation are not well understood. We have observed that lipid accumulation in hepatocytes induces expression of ligands specific to the activating immune receptor NKG2D. Tissue-resident innate-like T cells, most notably γδ T cells, are activated through NKG2D and secrete IL-17A. IL-17A licenses hepatocytes to produce chemokines that recruit proinflammatory cells into the liver, which causes NASH and fibrosis. NKG2D-deficient mice did not develop fibrosis in dietary models of NASH and had a decreased incidence of hepatic tumors. The frequency of IL-17A+ γδ T cells in the blood of patients with MAFLD correlated directly with liver pathology. Our findings identify a key molecular mechanism through which stressed hepatocytes trigger inflammation in the context of MAFLD.

MeSH terms

  • Animals
  • Hepatocytes / metabolism
  • Hepatocytes / pathology
  • Humans
  • Inflammation / pathology
  • Interleukin-17 / metabolism
  • Liver Cirrhosis / metabolism
  • Mice
  • NK Cell Lectin-Like Receptor Subfamily K
  • Non-alcoholic Fatty Liver Disease*
  • T-Lymphocytes / metabolism

Substances

  • Interleukin-17
  • NK Cell Lectin-Like Receptor Subfamily K
  • Klrk1 protein, mouse