Immune-Metabolic Regulation of Biliary Atresia

胆道闭锁（BA）是一种婴儿期胆汁淤积性肝病， 肝移植目前的证据支持的原则，即BA产生于一个异常的 对环境触发的免疫反应然而，疾病的确切机制仍然存在 未知虽然巨噬细胞（M β）与人和鼠BA有关，但M β与人和鼠BA有关。 异构的性质和代谢网络负责亲恢复与亲， 炎性M β极化尚未确定。我们的核心前提是， 与患者结局相关的巨噬细胞特异性免疫代谢特征将导致 新的预后生物标志物和细胞亚群特异性疗法，以延长无移植存活期。 我们是第一个在BA婴儿中确定预后代谢物特征的人， 诊断.我们已经证明血清精氨酸代谢物的明显变化， 多胺增加，在BA婴儿在诊断时，与增加 2岁时自体肝（SNL）生存率，尽管临床指标无基线差异 特色已知多胺可将巨噬细胞重编程为抗炎表型， 部分通过细胞凋亡（即凋亡细胞摄取）。我们的初步数据发现， 具有多胺高代谢特征的患者， 特征性单核细胞样M β（MLM，与 单核细胞）和血清GM-CSF。因此，我们假设招募的MLM促进肝脏 适应胆道梗阻;因此，MLM的代谢和表观遗传重编程， 抗炎表型与2岁时SNL相关。探讨 根据这一假设，我们将：1）确定血清精氨酸代谢物的预后作用，以及2） 鉴定与SNL相关细胞亚群特异性转录表型。

Biliary atresia (BA) is a cholestatic liver disease of infancy and is the leading cause of pediatric liver transplantation. Current evidence supports the principle that BA arises from an aberrant immune response to an environmental trigger. However, the exact mechanism of disease remains unknown. While macrophages (M) have been implicated in both human and murine BA, M are heterogeneous by nature and the metabolic networks responsible for pro-restorative vs pro- inflammatory M polarization have not been defined. Our central premise is that identifying macrophage-specific immune-metabolic signatures associated with patient outcome will lead to novel prognostic biomarkers and cell-subset specific therapies to prolong transplant-free survival. We have been the first to identify a prognostic metabolite signature in BA infants at the time of diagnosis. We have shown that distinct changes in serum arginine metabolites, particularly increased polyamines, in BA infants at the time of diagnosis was associated with increased survival with native liver (SNL) at the age of 2 years despite no baseline differences in clinical characteristics. Polyamines are known to reprogram M to an anti-inflammatory phenotype, in part through efferocytosis (i.e. apoptotic cell uptake). Our preliminary data found that BA patients with a polyamine-high metabolic signature had increased hepatic numbers of previously characterized monocyte-like M (MLM, increased expression for genes associated with monocytes) and serum GM-CSF. We thereby hypothesize that recruited MLM promote hepatic adaptation to biliary obstruction; thus, metabolic and epigenetic reprogramming of MLM towards and anti-inflammatory phenotype will be associated with SNL at 2 years of age. To investigate this hypothesis, we will: 1) define the prognostic role for serum arginine metabolites, and 2) identify cell subset specific transcriptional phenotypes associated with SNL.