Spinal cord injury causes liver pathology and metabolic dysfunction

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Spinal cord injured (SCI) individuals have significantly reduced lifespans compared to the general population, a statistic that has not changed in 30 years. One reason is “endocrine, metabolic and nutritional diseases”, which are increasing at alarming rates in the SCI population (2019 Models Systems report). This is evidenced by SCI individuals having increased prevalence of Metabolic Syndrome (MetS), the complications of which put them at a higher risk for diabetes, cardiovascular disease and stroke compared to the general population. A central feature of MetS and contributor to morbidity is hepatic pathology in the form of non-alcoholic steatohepatitis (NASH), a severe form of nonalcoholic fatty liver disease (NAFLD). NASH includes hepatic lipid accumulation (steatosis) and inflammation, which in turn cause hepatocyte damage and release of pro-inflammatory mediators. NASH likely facilitates subsequent systems-wide pathology after SCI. Experiments in this proposal are designed to identify mechanisms that initiate and sustain NASH in acute and chronic SCI. Focus will be on increased sympathetic input to the liver and consequent intracellular changes in the liver that drive inflammation and fat accumulation. We hypothesize that excess sympathetic input to the liver after SCI initiates pro-inflammatory cascades involving TNFa and NFkB, which in turn initiate hepatic fat accumulation and prolonged inflammation. We will use transgenic mouse technology as well as unbiased - omics approaches to comprehensively identify cellular changes in the liver induced by SCI that drive “neurogenic” NASH and subsequent features of MetS. Our long-term goal is to identify therapeutic targets that can interrupt the dysfunctional spinal cord/liver axis after SCI to restore liver homeostasis and improve overall metabolic health.