3.1. DEGs in AH datasets and single-gene GSEA of FABP4
The results of differential expression analysis showed that 1872 down-regulated and 1877 up-regulated genes were identified as DEGs in GSE142530 (Fig. 1A and C). Meanwhile, 3202 down-regulated and 2836 up-regulated genes were obtained from GSE167308 (Fig. 1B and D). Venn diagrams displayed 2201 overlapping genes related to AH between the two datasets, including 1094 down-regulated and 1107 up-regulated genes (Fig. 1E). We further analyzed the FABPs family and found 3 up-regulated genes in GSE142530, and 1 up-regulated and 2 down-regulated genes in GSE167308 (Fig. 1F and G). Among the whole FABPs family, only FABP4 was up-regulated in both AH datasets (Fig. 1F and G). GSEA showed that FABP4 was mainly involved in lipid metabolism, immunity, and inflammation associated pathways, including regulation of lipolysis in adipocytes, PI3K-Akt signaling pathway, Wnt signaling pathway, MAPK signaling pathway, chemokine signaling pathway, and Inflammatory mediator regulation of TRP channels (Fig. 1H-M).
3.2. Verification of FABP4 in AH datasets and expression of FABP4 in ALD patients
We combined the two AH datasets and removed batch effects by R software sva V3.46.0 package[15]. Moreover, using WGCNA analysis with the default-recommended parameters (Fig. 2A and 2B), 13 remarkable co-expression modules were identified (Fig. 2C). As indicated from the investigations of module-trait correlations, turquoise module and salmon module were related to AH (Fig. 2D). Given that the association of turquoise module and AH was the most significant, genes in the turquoise module were screened, and FABP4 was successfully identified (Fig. 2E). In order to assess the predictive value of FABP4 in AH, we generated ROC curves. The AUC for FABP4 was 0.82 (Fig. 2F). We carried out RF algorithm, SVM algorithm, and XGBoost algorithm to verify the predictive value of FABP4 in AH. The results showed that the AUCs for FABP4 with RF algorithm, SVM algorithm, and XGBoost algorithm were 0.83, 0.80, and 0.77 (Fig. 2G), suggesting that FABP4 had the high accuracy of predictive value. Next, we verified the expression of FABP4 in AH datasets. The results showed that FABP4 expression was up-regulated in AH compared with controls in the GSE142530 and GSE167308 datasets (all P < 0.05, Fig. 2H and I). To further verify the expression of FABP4 in ALD patients, the results of qRT-PCR and WB showed that the mRNA and protein levels of FABP4 in the liver tissues were increased compared with healthy controls (Fig. 2J and K). These results indicated that FABP4 is significantly elevated in the liver tissues of patients with ALD.
3.3. The expression of Fabp4 in the liver tissues of ASH model mice
We further examined the expression of FABP4 in ASH mice, which were fed the Lieber-DeCarli ethanol (5% v/v) liquid diet for 8 weeks plus single binges. The results of H&E and Oil Red O staining showed that the degree of liver injury and lipid deposition was worse in the EtOH-fed mice than that in the CD-fed mice (Fig. 3A). Serum levels of ALT, AST, TG, and TC increased in the EtOH-fed compared to the CD-fed (Fig. 3B-E). Moreover, the hepatic levels of TNF-α, IL-6, TG, and TC showed an ascending trend after alcohol intake compared with the CD-fed groups (Fig. 3F-I). In addition, the mRNA and protein levels of Fabp4 in the liver tissues of ASH mice were increased (Fig. 3J and K). To sum up, the expression of Fabp4 was elevated in the liver tissues of ASH mice.
3.4. Fabp4 deficiency reduced hepatic lipid deposition and liver injury in ASH mice
To further explore the role of Fabp4 on the progression in the ASH mice, WT and Fabp4 knockout (Fabp4−/−) mice were fed the Lieber-DeCarli ethanol (5% v/v) liquid diet for 8 weeks plus single binges. The expression of Fabp4 was detected by qRT-PCR and WB. There is almost no expression of Fabp4 in the liver tissues of Fabp4−/− mice (Fig. 4A and B). The results of H&E and Oil Red O staining showed that compared with the WT mice, hepatic lipid droplet accumulation and liver injury was obviously reduced in Fabp4−/− mice (Fig. 4C). We also observed a reduction of serum ALT and AST in Fabp4−/− mice compared to WT mice (Fig. 4D and E). Moreover, the hepatic levels of TG and TC were decreased in Fabp4−/− mice (Fig. 4F and G). In addition, the hepatic levels of TNF-α and IL-6 were reduced in FABP4−/− mice (Fig. 4H and I). The above results indicated that Fabp4 deficiency ameliorated hepatic lipid deposition and liver injury in ASH mice.
3.5. Transcriptional profiling of the liver tissue from WT and Fabp4-/- ASH mice and bioinformatics analysis
To further investigate the mechanisms of Fabp4 in the development of ASH, we performed transcriptional profiling of the liver tissues of ASH mice. The results of differential expression analysis showed that a total of 964 genes, including 359 down-regulated genes and 605 up-regulated genes, were identified as DEGs in the liver tissues of WT and Fabp4−/− mice (Fig. 5A and B). The top 50 DEGs, including 30 up-regulated genes and 20 down-regulated genes were exhibited in the heatmaps (Fig. 5C). We conducted gene set enrichment analysis of the DEGs. Cell cycle, DNA replication, cell adhesion molecules, B cell receptor signaling pathway, focal adhesion, and phagosome were considered to be the most highly enriched pathways (Fig. 5D).
We conducted GO and KEGG pathway enrichment analysis of the DEGs. The results showed that the significantly enriched BP included cell chemotaxis, regulation of cell cycle phase transition, leukocyte chemotaxis, negative regulation of cell cycle process, and negative regulation of cell cycle phase transition (Fig. 5E). In the CC category, spindle pole, microtubule, collagen-containing extracellular matrix, myelin sheath, and replication fork were the top 5 enriched items (Fig. 5F). As for MF, the most enriched terms were tau protein binding, phosphatase binding, protein serine/threonine kinase activity, extracellular matrix structural constituent, and transmembrane-ephrin receptor activity (Fig. 5G). We also performed the GO functional enrichment analysis in down-regulated and up-regulated DEGs, respectively. The results showed that acute inflammatory response, acute-phase response, reactive oxygen species biosynthetic process, and fat cell differentiation were significantly enriched in down-regulated DEGs (Fig. 5H). However, negative regulation of cell adhesion, negative regulation of cell cycle, negative regulation of immune system process, and negative regulation of leukocyte activation were the most enriched items in up-regulated DEGs (Fig. 5I). Subsequently, the DEGs were subjected to KEGG pathway enrichment analysis. Cell adhesion molecules, p53 signaling pathway, cell cycle, insulin resistance, PI3K-Akt signaling pathway, IL-17 signaling pathway, and alcoholic liver disease were considered to be the most highly enriched pathways (Fig. 5J).
3.6. FABP4 deficiency attenuated the progression of ASH in mice via the p53 signaling pathway
Transcriptional profiling and integrative bioinformatics analysis showed that Fabp4 was related to p53 signaling pathway, insulin resistance, and PI3K-Akt signaling pathway (Fig. 5J). Thus, we measured the critical factors in these pathways. The hepatic protein of p53 was greatly reduced in Fabp4−/− ASH mice compared with WT mice (Fig. 6A). The p53 signaling pathway associated molecules such as Casp3, Bax and Bcl2 were further evaluated. The results showed that the protein levels of Casp3 and Bax, both related to apoptosis, were decreased, while Bcl-2, which is related to anti-apoptosis, was increased in Fabp4−/− mice (Fig. 6A). The mRNA and protein levels of IRS-1, Pi3k, and Akt associated with alleviating insulin resistance were increased (Fig. 6B and C). Taken together, these results demonstrate that FABP4 regulates the p53 signaling pathway and insulin/PI3K/AKT signaling pathway in ASH mice.
Previous studies have shown that inhibition of p53 could induce hepatic SIRT1 upregulation [16–18]. Therefore, qRT-PCR and WB were used to detect the expression of SIRT1 in ASH mice. The results showed that the mRNA and protein levels of SIRT1 in liver tissues of FABP4−/− mice were significantly increased (Fig. 6D and E). The expression levels of lipid catabolic-related genes PPARα, AMPK, and CPT-1 and lipid anabolic-related genes ACC, SREBP1, SCD1, and FASN were detected. The results showed that the mRNA and protein levels of PPARα, AMPK, and CPT-1 were increased (Fig. 6F and G); in contrast, the expression of ACC, SREBP1, SCD1, and FASN were decreased (Fig. 6H and I). These results demonstrate that FABP4 deficiency inhibits fatty acid synthesis and promotes fatty acid oxidation in ASH mice through the p53 signaling pathway and SIRT1 signaling pathway.
It has been reported that SIRT1 inhibits the expression of inflammatory factors, such as TNF-α, IL-1β, and IL-6, by directly inhibiting the NF-κB signaling pathway[19]. Thus, we detected the hepatic expression of related factors in the NF-κB signaling pathway by qRT-PCR and WB. As expected, the results showed that the mRNA and protein expression of IKK and NF-κB decreased in FABP4−/− mice (Fig. 6J and K). In conclusion, FABP4 deficiency reduces hepatic inflammation in ASH mice by mediating the SIRT1 signaling pathway.
3.7. FABP4 affected the proportion of macrophage M1/M2 and the expression of pro-inflammatory factors in ASH.
Previous studies have suggested that activation of immune can accelerate the progression of AH[20, 21]. We thus aimed to explore the relationship between FABP4 and the immune cells infiltration in AH. We performed CIBERSORT algorithm to analyze the immune cell phenotypes in GSE142530. These results demonstrate that AH samples had a lower proportion of macrophages M2 compared to control samples, and FABP4 showed a negative correlation with macrophages M2 (supplementary Fig. S1A-D). To further explore the effects of FABP4 in macrophages, we conducted GSEA of the DEGs in GSE73173. These results suggest that the effects of exogenous FABP4 in RAW264.7 macrophages are mainly focused on immunity, inflammation and lipid metabolism (supplementary Fig. S1E-I).
FABP4 is highly expressed in macrophages, especially during the inflammatory activated station [22, 23]. We performed CIBERSORT algorithm to analyze the 25 immune cell phenotypes including macrophages in the liver tissues of WT and FABP4−/− mice. The proportions of macrophages M1 in FABP4−/− mice was significantly lower than that in WT mice (P < 0.01). However, in comparison with WT mice, FABP4−/− mice had a higher proportion of macrophages M2. Interestingly, the proportion of macrophages M2 in WT mice was zero, and the proportion of macrophages M2 in FABP4−/− mice was 6% (Fig. 7A and B). As indicated from the correlation heatmap of the 23 types of immune cells, macrophages are significantly correlated with some immune cells (Fig. 7C). We then sought to explore the relationships between key genes and infiltrated immune cells in ASH. Based on the results of correlation analysis, p53, NLRP3, IL-1β, and CXCL-1 are positively correlated with macrophages M1 (r = 0.66, 0.6, 0.6, and 0.83, both P < 0.05) (Fig. 7D). FABP4 showed a negative correlation with macrophages M2 (r = − 0.52) and SIRT1 displayed a negative correlation with mast cells (r=-0.65, P < 0.001) (Fig. 7D).Thus, we investigated the relationship between the FABP4 and macrophage in ASH mouse. Immunohistochemistry analysis showed that F4/80 deposition was lower in FABP4−/− mice as compared to WT mice (Fig. 7E). Similarly, the mRNA and protein levels of F4/80 were also decreased in livers of FABP4−/− mice (Fig. 7F and G). Furthermore, the qRT-PCR results showed that inflammatory-related genes, such as Tnf-α, Il-6, Il-1β, Il-8, Trailr1, Iy6g, Mcp-1, and Cxcl-1, were downregulated in the FABP4−/− mice (Fig. 7H). The protein levels of NLRP3, CASP1, pro-IL-1β, and IL-1β were decreased in the FABP4−/− mice (Fig. 7I). These results suggest that FABP4 deficiency prevents liver inflammation in ASH mice by reducing the proportion of Macrophages M1.