Therapeutic targeting of adipose tissue macrophages ameliorates liver fibrosis in non-alcoholic fatty liver disease

Celia Martínez–Sánchez, Octavi Bassegoda, Hongping Deng, Xènia Almodóvar, Ainitze Ibarzabal, Ana de Hollanda, Raquel–Adela –A Martínez García de la Torre, Delia Blaya, Silvia Ariño, Natalia Jiménez-Esquivel, Beatriz Aguilar-Bravo, Julia Vallverdú, Carla Montironi, Oscar Osorio-Conles, Yiliam Fundora, Francisco Javier Sánchez Moreno, Alicia G. Gómez-Valadés, Laia Aguilar-Corominas, Anna Soria, Elisa PoseAdrià Juanola, Marta Cervera, Martina Perez, Virginia Hernández-Gea, Silvia Affò, Kelly S. Swanson, Joana Ferrer-Fàbrega, Jose Maria Balibrea, Pau Sancho-Bru, Josep Vidal, Pere Ginès, Andrew M. Smith, Isabel Graupera, Mar Coll

Research output: Contribution to journalArticlepeer-review


Background & Aims: : The accumulation of adipose tissue macrophages (ATMs) in obesity has been associated with hepatic injury. However, the contribution of ATMs to hepatic fibrosis in non-alcoholic fatty liver disease (NAFLD) remains to be elucidated. Herein, we investigate the relationship between ATMs and liver fibrosis in patients with patients with NAFLD and evaluate the impact of modulation of ATMs over hepatic fibrosis in an experimental non-alcoholic steatohepatitis (NASH) model. Methods: Adipose tissue and liver biopsies from 42 patients with NAFLD with different fibrosis stages were collected. ATMs were characterised by immunohistochemistry and flow cytometry and the correlation between ATMs and liver fibrosis stages was assessed. Selective modulation of the ATM phenotype was achieved by i.p. administration of dextran coupled with dexamethasone in diet-induced obesity and NASH murine models. Chronic administration effects were evaluated by histology and gene expression analysis in adipose tissue and liver samples. In vitro crosstalk between human ATMs and hepatic stellate cells (HSCs) and liver spheroids was performed. Results: Patients with NAFLD presented an increased accumulation of pro-inflammatory ATMs that correlated with hepatic fibrosis. Long-term modulation of ATMs significantly reduced pro-inflammatory phenotype and ameliorated adipose tissue inflammation. Moreover, ATMs modulation was associated with an improvement in steatosis and hepatic inflammation and significantly reduced fibrosis progression in an experimental NASH model. In vitro, the reduction of the pro-inflammatory phenotype of human ATMs with dextran–dexamethasone treatment reduced the secretion of inflammatory chemokines and directly attenuated the pro-fibrogenic response in HSCs and liver spheroids. Conclusions: Pro-inflammatory ATMs increase in parallel with fibrosis degree in patients with NAFLD and their modulation in an experimental NASH model improves liver fibrosis, uncovering the potential of ATMs as a therapeutic target to mitigate liver fibrosis in NAFLD. Impact and implications: We report that human adipose tissue pro-inflammatory macrophages correlate with hepatic fibrosis in non-alcoholic fatty liver disease (NAFLD). Furthermore, the modulation of adipose tissue macrophages (ATMs) by dextran-nanocarrier conjugated with dexamethasone shifts the pro-inflammatory phenotype of ATMs to an anti-inflammatory phenotype in an experimental murine model of non-alcoholic steatohepatitis. This shift ameliorates adipose tissue inflammation, hepatic inflammation, and fibrosis. Our results highlight the relevance of adipose tissue in NAFLD pathophysiology and unveil ATMs as a potential target for NAFLD.

Original languageEnglish (US)
Article number100830
JournalJHEP Reports
Issue number10
StatePublished - Oct 2023


  • Adipose tissue inflammation
  • Dextran dexamethasone conjugates
  • Drug delivery
  • Liver injury
  • Nanomedicine
  • Nanoparticle
  • Non-alcoholic steatohepatitis
  • Targeted therapy

ASJC Scopus subject areas

  • Gastroenterology
  • Internal Medicine
  • Immunology and Allergy
  • Hepatology


Dive into the research topics of 'Therapeutic targeting of adipose tissue macrophages ameliorates liver fibrosis in non-alcoholic fatty liver disease'. Together they form a unique fingerprint.

Cite this