Abstract
Background
The pathogenesis of liver fibrosis in biliary atresia (BA) is unclear. Epidermal growth factor (EGF) plays a vital role in liver fibrosis. This study aims to investigate the expression of EGF and the mechanisms of its pro-fibrotic effects in BA.
Methods
EGF levels in serum and liver samples of BA and non-BA children were detected. Marker proteins of EGF signaling and epithelial-mesenchymal transition (EMT) in liver sections were evaluated. Effects of EGF on intrahepatic cells and the underlying mechanisms were explored in vitro. Bile duct ligation (BDL) mice with/without EGF antibody injection were used to verify the effects of EGF on liver fibrosis.
Results
Serum levels and liver expression of EGF elevated in BA. Phosphorylated EGF receptor (p-EGFR) and extracellular regulated kinase 1/2 (p-ERK1/2) increased. In addition, EMT and proliferation of biliary epithelial cells were present in BA liver. In vitro, EGF induced EMT and proliferation of HIBEpic cells and promoted IL-8 expression in L-02 cells by phosphorylating ERK1/2. And EGF activated LX-2 cells. Furthermore, EGF antibody injection reduced p-ERK1/2 levels and alleviated liver fibrosis in BDL mice.
Conclusion
EGF is overexpressed in BA. It aggravates liver fibrosis through EGF/EGFR-ERK1/2 pathway, which may be a therapeutic target for BA.
Impact
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The exact pathogenesis of liver fibrosis in BA is unknown, severely limiting the advancement of BA treatment strategies.
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This study revealed that serum and liver tissue levels of EGF were increased in BA, and its expression in liver tissues was correlated with the degree of liver fibrosis. EGF may promote EMT and proliferation of biliary epithelial cells and induce IL-8 overexpression in hepatocytes through EGF/EGFR-ERK1/2 signaling pathway. EGF can also activate HSCs in vitro.
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The EGF/EGFR-ERK1/2 pathway may be a potential therapeutic target for BA.
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Data availability
The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.
References
Bezerra, J. A. et al. Biliary atresia: Clinical and research challenges for the Twenty-First century. Hepatology 68, 1163–1173 (2018).
Wang, Z. et al. Five-year native liver survival analysis in biliary atresia from a single large Chinese center: The death/liver transplantation hazard change and the importance of rapid early clearance of jaundice. J. Pediatr. Surg. 54, 1680–1685 (2019).
Hardesty, J. E. et al. Effect of epidermal growth factor treatment and polychlorinated biphenyl exposure in a Dietary-Exposure mouse model of steatohepatitis. Environ. Health Persp. 129, 37010 (2021).
Xu, H. et al. EGF neutralization antibodies attenuate liver fibrosis by inhibiting myofibroblast proliferation in bile duct ligation mice. Histochem. Cell Biol. 154, 107–116 (2020).
Rodrigues, M. A. et al. Inositol 1,4,5-trisphosphate receptor type 3 (ITPR3) is overexpressed in cholangiocarcinoma and its expression correlates with S100 calcium-binding protein A4 (S100A4). Biomed. Pharmacother. 145, 112403 (2022).
Komuves, L. G., Feren, A., Jones, A. L. & Fodor, E. Expression of epidermal growth factor and its receptor in cirrhotic liver disease. J. Histochem. Cytochem. 48, 821–830 (2000).
Madadi-Sanjani, O. et al. Growth factors assessed during kasai procedure in liver and serum are not predictive for the postoperative liver deterioration in infants with biliary atresia. J. Clin. Med. 10, 1978 (2021).
Vejchapipat, P. et al. Serum transforming growth factor-beta1 and epidermal growth factor in biliary atresia. Eur. J. Pediatr. Surg. 18, 415–418 (2008).
Ningappa, M. et al. The role of ARF6 in biliary atresia. PLoS One 10, e138381 (2015).
Chen, Y. et al. Study on the relationship between hepatic fibrosis and epithelial-mesenchymal transition in intrahepatic cells. Biomed. Pharmacother. 129, 110413 (2020).
Zhou, T. et al. Knockdown of vimentin reduces mesenchymal phenotype of cholangiocytes in the Mdr2(-/-) mouse model of primary sclerosing cholangitis (PSC). EBioMedicine 48, 130–142 (2019).
Rubio, K., Castillo-Negrete, R. & Barreto, G. Non-coding RNAs and nuclear architecture during epithelial-mesenchymal transition in lung cancer and idiopathic pulmonary fibrosis. Cell. Signal. 70, 109593 (2020).
Overstreet, J. M. et al. Selective activation of epidermal growth factor receptor in renal proximal tubule induces tubulointerstitial fibrosis. FASEB J. 31, 4407–4421 (2017).
The French METAVIR Cooperative Study Group. Intraobserver and interobserver variations in liver biopsy interpretation in patients with chronic hepatitis C. Hepatology 20, 15–20 (1994).
Lamouille, S., Xu, J. & Derynck, R. Molecular mechanisms of epithelial-mesenchymal transition. Nat. Rev. Mol. cell Biol. 15, 178–196 (2014).
Godbole, N. et al. Prognostic and pathophysiologic significance of IL-8 (CXCL8) in biliary atresia. J. Clin. Med. 10, 2705 (2021).
Zhang, Y. et al. Potential mechanism of interleukin-8 production from lung cancer cells: An involvement of EGF-EGFR-PI3K-Akt-Erk pathway. J. Cell. Physiol. 227, 35–43 (2012).
Zhang, Y. et al. CXCL8(high) inflammatory B cells in the peripheral blood of patients with biliary atresia are involved in disease progression. Immunol. Cell Biol. 98, 682–692 (2020).
Kuriyama, S. et al. Sequential assessment of the intrahepatic expression of epidermal growth factor and transforming growth factor beta 1. Int. J. Mol. Med. 19, 317–324 (2007).
St, H. R., Hradek, G. T. & Jones, A. L. Hepatic sequestration and biliary secretion of epidermal growth factor: Evidence for a high-capacity uptake system. Proc. Natl. Acad. Sci. USA 80, 3797–3801 (1983).
Kim, S. M. et al. Death-Associated protein 6 (Daxx) alleviates liver fibrosis by modulating smad2 acetylation. Cells 10, 1742 (2021).
Tang, J. et al. MiR-944 suppresses EGF-Induced EMT in colorectal cancer cells by directly targeting GATA6. Onco Targets Ther. 14, 2311–2325 (2021).
Sheng, W. et al. Musashi2 promotes EGF-induced EMT in pancreatic cancer via ZEB1-ERK/MAPK signaling. J. Exp. Clin. Cancer Res. 39, 16 (2020).
Hu, Y. et al. The long non-coding RNA LIMT inhibits metastasis of hepatocellular carcinoma and is suppressed by EGF signaling. Mol. Biol. Rep. 49, 4749–4757 (2022).
Claperon, A. et al. EGF/EGFR axis contributes to the progression of cholangiocarcinoma through the induction of an epithelial-mesenchymal transition. J. Hepatol. 61, 325–332 (2014).
Al, S. M. et al. Senescent cholangiocytes release extracellular vesicles that alter target cell phenotype via the epidermal growth factor receptor. Liver Int. 40, 2455–2468 (2020).
Deng, Y. H. et al. Analysis of biliary epithelial-mesenchymal transition in portal tract fibrogenesis in biliary atresia. Dig. Dis. Sci. 56, 731–740 (2011).
Siyu, P. et al. The role of GLI in the regulation of hepatic Epithelial-Mesenchymal transition in biliary atresia. Front Pediatr. 10, 861826 (2022).
Harada, K. et al. Epithelial-mesenchymal transition induced by biliary innate immunity contributes to the sclerosing cholangiopathy of biliary atresia. J. Pathol. 217, 654–664 (2009).
Xiao, Y. et al. The expression of epithelial-mesenchymal transition-related proteins in biliary epithelial cells is associated with liver fibrosis in biliary atresia. Pediatr. Res. 77, 310–315 (2015).
Sheng, W. et al. Numb-PRRL promotes TGF-beta1- and EGF-induced epithelial-to-mesenchymal transition in pancreatic cancer. Cell Death Dis. 13, 173 (2022).
Jeong, Y. J. et al. Bee venom suppresses EGF-Induced Epithelial-Mesenchymal transition and tumor invasion in lung cancer cells. Am. J. Chin. Med 47, 1869–1883 (2019).
Scholten, D. et al. Genetic labeling does not detect epithelial-to-mesenchymal transition of cholangiocytes in liver fibrosis in mice. Gastroenterology 139, 987–998 (2010).
Chu, A. S. et al. Lineage tracing demonstrates no evidence of cholangiocyte epithelial-to-mesenchymal transition in murine models of hepatic fibrosis. Hepatology 53, 1685–1695 (2011).
Taura, K., Iwaisako, K., Hatano, E. & Uemoto, S. Controversies over the epithelial-to-mesenchymal transition in liver fibrosis. J. Clin. Med. 5, 9 (2016).
Robertson, H. et al. Biliary epithelial-mesenchymal transition in posttransplantation recurrence of primary biliary cirrhosis. Hepatology 45, 977–981 (2007).
Perugorria, M. J. et al. The epidermal growth factor receptor ligand amphiregulin participates in the development of mouse liver fibrosis. Hepatology 48, 1251–1261 (2008).
Santamaria, E. et al. The epidermal growth factor receptor ligand amphiregulin protects from cholestatic liver injury and regulates bile acids synthesis. Hepatology 69, 1632–1647 (2019).
Arafa, R. S. et al. Significant hepatic expression of IL-2 and IL-8 in biliary atresia compared with other neonatal cholestatic disorders. Cytokine 79, 59–65 (2016).
El-Faramawy, A. A., El-Shazly, L. B., Abbass, A. A. & Ismail, H. A. Serum IL-6 and IL-8 in infants with biliary atresia in comparison to intrahepatic cholestasis. Trop. Gastroenterol. 32, 50–55 (2011).
Kim, S. et al. Correlation of immune markers with outcomes in biliary atresia following intravenous immunoglobulin therapy. Hepatol. Commun. 3, 685–696 (2019).
Bessho K. et al. Gene expression signature for biliary atresia and a role for interleukin-8 in pathogenesis of experimental disease. Hepatology (Baltimore, Md.) 60 (2014).
Fuchs, B. C. et al. Epidermal growth factor receptor inhibition attenuates liver fibrosis and development of hepatocellular carcinoma. Hepatology 59, 1577–1590 (2014).
Funding
This study was funded by Major Special Projects of Public Health Science and Technology in Tianjin (21ZXGWSY00070) and Xinjiang Uygur Autonomous Region Science Foundation Projects (2021D01A38).
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Q.Z. and M.L. contributed to design, data acquisition and analysis, drafted the manuscript, and critically revised the manuscript; L.C. contributed to data acquisition, analysis, and interpretation; C.Z. contributed to data acquisition and analysis; Y.Z. contributed to data acquisition and analysis; G.L. contributed to data acquisition; F.Y. contributed to data acquisition; J.Z. contributed to the conception, design, data acquisition, analysis, and interpretation, drafted and critically revised the manuscript.
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Zheng, Q., Li, M., Chen, L. et al. Potential therapeutic target of EGF on bile duct ligation model and biliary atresia children. Pediatr Res 94, 1297–1307 (2023). https://doi.org/10.1038/s41390-023-02592-4
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DOI: https://doi.org/10.1038/s41390-023-02592-4
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