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      Endogenous annexin A1 is a novel protective determinant in nonalcoholic steatohepatitis in mice

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          Abstract

          Annexin A1 (AnxA1) is an effector of the resolution of inflammation and is highly effective in terminating acute inflammatory responses. However, its role in chronic settings is less investigated. Because changes in AnxA1 expression within adipose tissue characterize obesity in mice and humans, we queried a possible role for AnxA1 in the pathogenesis of nonalcoholic steatohepatitis (NASH), a disease commonly associated with obesity. NASH was induced in wild-type (WT) and AnxA1 knockout (AnxA1 KO) C57BL/6 mice by feeding a methionine-choline deficient (MCD) diet up to 8 weeks. In MCD-fed WT mice, hepatic AnxA1 increased in parallel with progression of liver injury. This mediator was also detected in liver biopsies from patients with NASH and its degree of expression inversely correlated with the extent of fibrosis. In both humans and rodents, AnxA1 production was selectively localized in liver macrophages. NASH in AnxA1 KO mice was characterized by enhanced lobular inflammation resulting from increased macrophage recruitment and exacerbation of the M1 phenotype. Consistently, in vitro addition of recombinant AnxA1 to macrophages isolated from NASH livers down-modulated M1 polarization through stimulation of interleukin-10 production. Furthermore, the degree of hepatic fibrosis was enhanced in MCD-fed AnxA1 KO mice, an effect associated with augmented liver production of the profibrotic lectin, galectin-3. Accordingly, AnxA1 addition to isolated hepatic macrophages reduced galectin-3 expression. Conclusions: Macrophage-derived AnxA1 plays a functional role in modulating hepatic inflammation and fibrogenesis during NASH progression, suggesting the possible use of AnxA1 analogs for therapeutic control of this disease.

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          Annexin A1 and glucocorticoids as effectors of the resolution of inflammation.

          Glucocorticoids are widely used for the management of inflammatory diseases. Their clinical application stems from our understanding of the inhibitory effect of the corticosteroid hormone cortisol on several components of the immune system. Endogenous and exogenous glucocorticoids mediate their multiple anti-inflammatory effects through many effector molecules. In this Opinion article, we focus on the role of one such effector molecule, annexin A1, and summarize the recent studies that provide insight into its molecular and pharmacological functions in immune responses. In addition, we propose a model in which glucocorticoids regulate the expression and function of annexin A1 in opposing ways in innate and adaptive immune cells to mediate the resolution of inflammation.
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            Resolution of inflammation: an integrated view

            Resolution of inflammation is a coordinated and active process aimed at restoration of tissue integrity and function. This review integrates the key molecular and cellular mechanisms of resolution. We describe how abrogation of chemokine signalling blocks continued neutrophil tissue infiltration and how apoptotic neutrophils attract monocytes and macrophages to induce their clearance. Uptake of apoptotic neutrophils by macrophages reprograms macrophages towards a resolving phenotype, a key event to restore tissue homeostasis. Finally, we highlight the therapeutic potential that derives from understanding the mechanisms of resolution.
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              Pathology of nonalcoholic fatty liver disease.

              Nonalcoholic fatty liver disease (NAFLD) is a significant complication of obesity and is recognized as the hepatic manifestation of the metabolic syndrome. The process occurs in adults and children and is characterized by the presence of increased amounts of fat in the liver (steatosis). With inflammation, cell death and scarring (fibrosis), the process may result in end-stage liver disease, or be a precursor for hepatocellular carcinoma. Excess hepatic fat is now recognized as an independent marker for increased cardiovascular risk. Even though imaging studies and laboratory-based tests are accurate at detecting significant steatosis and/or advanced fibrosis, respectively, the diagnosis and characterization of NAFLD ultimately depend on histopathologic evaluation, as the parenchymal alterations that comprise the spectrum of injury in NAFLD include patterns as well as specific lesions. Histologic findings in children may differ from those in adults. In this Review, the histologic features that are diagnostic and discriminatory between steatosis and steatohepatitis, the significance of the distinction between steatosis and steatohepatitis, the types and locations of fibrosis, and the histologic variances between adult and pediatric NAFLD are discussed. Clinical advantages as well as potential drawbacks of liver biopsy are presented. Current pathophysiologic concepts relevant to histologic findings are discussed.
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                Author and article information

                Journal
                Hepatology
                Hepatology
                hep
                Hepatology (Baltimore, Md.)
                BlackWell Publishing Ltd (Oxford, UK )
                0270-9139
                1527-3350
                August 2014
                12 May 2014
                : 60
                : 2
                : 531-544
                Affiliations
                [1 ]Department of Health Sciences and Interdisciplinary Research Center for Autoimmune Diseases, University “Amedeo Avogadro” of East Piedmont Novara, Italy
                [2 ]Cardiovascular Research Institute Maastricht Department of Biochemistry, Maastricht University Maastricht, The Netherlands
                [3 ]William Harvey Research Institute, Queen Mary University of London, London, United Kingdom; and Departments of Turin Italy
                [4 ]Clinical and Biological Sciences, University of Turin Turin, Italy
                [5 ]Medical Sciences, University of Turin Turin, Italy
                Author notes
                Address reprint requests to: Prof. Emanuele Albano, M.D., Ph.D., Department of Health Science, University “Amedeo Avogadro” of East Piedmont, Via Solaroli 17, 28100 Novara, Italy. E-mail: emanuele.albano@ 123456med.unipmn.it ; fax: +39 0321 620421.
                * These authors share senior authorship.

                This work has been supported by grants from the Fondazione Cariplo, Milan, Italy (grant no.: 2011-0470), The Wellcome Trust (Programme 086867/Z/08/Z) and, in part, The William Harvey Research Foundation (London, UK). I.L. Ph.D. training at the Scuola di Alta Formazione of the University of East Piendmont was supported by the Compagnia di San Paolo (Turin, Italy) and partially by the Fondazione Cariplo (NutriAl Network 2010).

                View this article online at wileyonlinelibrary.com.

                Potential conflict of interest: Nothing to report.

                Article
                10.1002/hep.27141
                4258084
                24668763
                25ae4e2b-a6a4-46f4-8ee5-c8ce4604a900
                © 2014 The Authors. H epatology published by Wiley on behalf of the American Association for the Study of Liver Diseases.

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 23 January 2014
                : 19 March 2014
                Categories
                Steatohepatitis/Metabolic Liver Disease

                Gastroenterology & Hepatology
                Gastroenterology & Hepatology

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