NAFLD is one of the major causes of liver disease worldwide and will probably emerge as the leading cause of end-stage liver disease in the coming decades. NAFLD affecting adults and children is often associated with metabolic comorbidity, potentially placing a growing burden on health care and economies [24]. NASH occurs in 2–5% of the general population [25] and is characterized by necroinflammation and a faster fibrosis progression than that of NAFLD [26]. The pathogenesis of NASH is multifactorial and not yet completely understood. Notably, innate immunity is a major contributing factor in which resident KCs and recruited MDMs play a central part in disease progression [25]. In the healthy state, most macrophages in the liver are resident KCs derived from the yolk sac, presenting in the hepatic sinusoids and the space of Disse, and interacting with HSCs, hepatocytes, and liver sinusoidal endothelial cells [12, 27]. However, during the progression of NASH, a large number of MDMs from the bone marrow infiltrate the liver, which has proinflammatory effects that aggravate liver injury [28]. One portion of the MDMs evolves into MoKCs that fill the niche of progressively dying resident KCs and persists in the liver, and another portion evolves into LAMs [28]. LAMs exhibit greater transcriptional alterations and lower lipid storage efficiency than resident KCs [12].
The biological heterogeneity and interactions between recruited MDMs and resident KCs in NASH have been difficult to resolve, and traditional M1 and M2 nomenclature fails to adequately describe the diversity of macrophage phenotypes. In recent years, the heterogeneity and dynamic transition of macrophages in NASH has been more successfully investigated using scRNA-seq [29]. Xiong reported that over 93% of Trem2hi-KC cells were derived from NASH livers, indicating that this was a unique macrophage subset associated with NASH pathogenesis [6]. Sabine described a reduction in mature Timd4+ KCs and the accumulation of monocyte-derived Timd4− macrophages in the livers of NASH mice [29]. In this study, we collected liver tissues from NASH and control mice to isolate single cells and perform scRNA-seq. Ultimately, 8229 NPCs were included in the data analysis, and 21 major cell clusters were found based on cell-specific markers. Macrophages, as the second largest proportion of NPCs, could be divided into 3 main clusters with a total of 1115 cells. Consistent with previous reports [12], these 3 clusters were identified as resident KCs (Cluster 2), LAMs (Cluster 13) and MoKCs (Cluster 19).
We focused on representative DEGs and GO and KEGG enrichment of Clusters 2 and 13. First, the features of single-LAMs in Cluster 13 were described. In NASH mouse livers, the proportion of single-LAMs in Cluster 13 was obviously increased. Cx3cr1 (a chemokine receptor of fractalkine), which is related to hepatic fat accumulation and liver damage in NAFLD [30–31], is a specific marker for LAMs [12]. In our study, nearly 93% of single-LAMs in Cluster 13 specifically expressed Cx3cr1. The cell functions of Cluster 13 were mainly involved in tumor necrosis factor production and chemokine binding. Based on KEGG enrichment, Cluster 13 may exert proinflammatory effects via the MAPK pathway to exacerbate NASH. Zhang demonstrated that MAPK could promote nutritional steatohepatitis through M1 polarization [32]. Therefore, we speculated that increasing Cx3crl+ single-LAMs distributed in Cluster 13 would play a proinflammatory role in NASH. Although in NASH mouse livers the proportion of resident single KCs of Cluster 2 was markedly decreased, it remained the dominant macrophage subset. Nearly 82% of resident single KCs in Cluster 2 specifically expressed Cd163, which is an M2 macrophage-specific marker [17]. The single KCs of Cluster 2 were identified by the general expression of Timd4, which is the marker gene of resident KCs [33]. Cd163 was then found to be more suitable for labeling resident single KCs with high specificity and enrichment in Cluster 2. The cell functions of Cluster 2 may be related to endocytosis and the inflammatory response. Based on KEGG enrichment, the PPAR pathway was found to be the most dysregulated, which has been indicated to ameliorate NAFLD by activating macrophages [34]. Therefore, an inhibited subgroup of Cd163+ resident single-KCs was selected and suggested to have a protective effect in NASH.
Cluster 2 expressed other specific DEGs, including Kcnj16, Chp2, Ccdc148, Vsig4 and Folr2, which were all downregulated in lipotoxic macrophages. Vsig4 is a membrane protein that belongs to the complement receptor of the immunoglobulin superfamily [19]. Vsig4+ KCs can induce and maintain immune tolerance in hepatic T and NKT cells, and Vsig4 had therapeutic effects on immune-mediated liver injury [35]. Clearance of microbiota-derived products from the bloodstream by Vsig4+ KCs in mouse livers ameliorated the development of obesity-related tissue inflammation and metabolic disease [36]. Notably, in our study, similar to Cd163, Vsig4 was enriched in and specific to Cluster 2. Nearly 96% of single cells in Cluster 2 were Vsig4+, and the percent fold change (pct-FC) was the 9th highest. Vsig4+-KCs were mainly concentrated in the pericentral venous region and obviously decreased in liver tissues of NASH mice (MCD induced). Moreover, the lipotoxic environment dramatically decreased the number of Vsig4+ primary KCs. Interestingly, HCs and HSCs produced less lipid droplet accumulation, and proinflammatory protein (TNF-α) and profibrotic protein (α-SMA) responded to coculture with Vsig4+-KCs compared with those cocultured with KCs under PA stimulation. Taken together, these studies demonstrate that Vsig4+-KCs may ameliorate NASH by influencing hepatocytes or HSCs in a lipotoxic environment. The dynamic reduction in the percentage of Vsig4+-KCs in NASH may be one of the factors driving disease progression.
In short, by using scRNA-seq, we revealed the heterogeneity and transformation of two single macrophage subsets in NASH mice based on the enrichment of DEGs, GO and KEGG. Furthermore, a group of Vsig4 + resident single-KCs was shown to improve hepatic inflammation and fibrosis in NASH.