title: A systems biology approach to the pathogenesis of obesity-related nonalcoholic fatty liver disease using reverse phase protein microarrays for multiplexed cell signaling analysis.
abstract: Nonalcoholic fatty liver disease (NAFLD) is a common cause of chronic liver disease. Omental adipose tissue, a biologically active organ secreting adipokines and cytokines, may play a role in the development of NAFLD. We tested this hypothesis with reverse-phase protein microarrays (RPA) for multiplexed cell signaling analysis of adipose tissue from patients with NAFLD. Omental adipose tissue was obtained from 99 obese patients. Liver biopsies obtained at the time of surgery were all read by the same hepatopathologist. Adipose tissue was exposed to rapid pressure cycles to extract protein lysates. RPA was used to investigate intracellular signaling. Analysis of 54 different kinase substrates and cell signaling endpoints showed that an insulin signaling pathway is deranged in different locations in NAFLD patients. Furthermore, components of insulin receptor-mediated signaling differentiate most of the conditions on the NAFLD spectrum. For example, PKA (protein kinase A) and AKT/mTOR (protein kinase B/mammalian target of rapamycin) pathway derangement accurately discriminates patients with NASH from those with the non-progressive forms of NAFLD. PKC (protein kinase C) delta, AKT, and SHC phosphorylation changes occur in patients with simple steatosis. Amounts of the FKHR (forkhead factor Foxo1)phosphorylated at S256 residue were significantly correlated with AST/ALT ratio in all morbidly obese patients. Furthermore, amounts of cleaved caspase 9 and pp90RSK S380 were positively correlated in patients with NASH. Specific insulin pathway signaling events are altered in the adipose tissue of patients with NASH compared with patients with nonprogressive forms of NAFLD.
  
  
  CONCLUSIONS
  These findings provide evidence for the role of omental fat in the pathogenesis, and potentially, the progression of NAFLD.
authors.affiliation: George Mason-Inova Health System's Translational Research Centers, VA, USA.
authors.forename: Valerie S
authors.initials: VS
authors.lastname: Calvert
authors.forename: Rochelle
authors.initials: R
authors.lastname: Collantes
authors.forename: Hazem
authors.initials: H
authors.lastname: Elariny
authors.forename: Arian
authors.initials: A
authors.lastname: Afendy
authors.forename: Ancha
authors.initials: A
authors.lastname: Baranova
authors.forename: Michael
authors.initials: M
authors.lastname: Mendoza
authors.forename: Zachary
authors.initials: Z
authors.lastname: Goodman
authors.forename: Lance A
authors.initials: LA
authors.lastname: Liotta
authors.forename: Emanuel F
authors.initials: EF
authors.lastname: Petricoin
authors.forename: Zobair M
authors.initials: ZM
authors.lastname: Younossi
mesh_terms: D000273:Adipose Tissue / Q000473:pathology / Q000503:physiopathology; D001706:Biopsy; D005234:Fatty Liver / Q000235:genetics* / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D009765:Obesity / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D040081:Protein Array Analysis / Q000379:methods*; D020543:Proteome / Q000235:genetics; D015398:Signal Transduction; D049490:Systems Biology / Q000379:methods
chemical_list: D020543:Proteome