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The role of Paneth cell α-defensin as a regulator of the intestinal microbiota in nonalcoholic steatohepatitis

中村, 駿太 北海道大学

2023.09.25

概要

Nonalcoholic steatohepatitis (NASH) is a chronic liver disease characterized by steatosis, liver
injury, inflammation, and fibrosis1. NASH is the crucial risk factor for cirrhosis and hepatocellular
carcinoma and regarded as one of the urgent unmet medical needs with the rapidly increasing number
of patients all over the world2. The liver fibrosis, which is a characteristic pathology of NASH, is
associated with an increased risk for mortality, so that the prevention of fibrosis is important3. Obesity
and type 2 diabetes are known to relate with NASH, and overnutrition is the principal cause of these
disease4. Because the fibrosis progression rate among nonalcoholic fatty liver disease (NAFLD)
patients is about 40% and NAFLD has a very variable natural history, a multiple hit hypothesis has
been considered in which NASH development proceeds through the complex crosstalk of varied
factors not limited to the liver5,6,7. The progression of NASH pathology is associated with
overnutrition8, yet the pathophysiological mechanisms of NASH are not well understood9.
The human intestine harbors intestinal microbiota with 40 trillion bacteria, which affects health and
disease via controlling host metabolism, immune function, and more10,11. On the other hand, dysbiosis,
disruption of intestinal microbiota homeostasis, is associated with many diseases including metabolic
disorders such as fatty liver and obesity12,13. The liver plays a central role in metabolism of the body
and directly communicate with intestine to form the “gut-liver axis”, and the intestinal microbiota has
a key role in the function of liver14. The metabolites, which are produced by the intestinal bacteria,
such as secondary bile acids and short-chain fatty acids (SCFA) regulate liver fatty acid synthesis and
bile acid synthesis15,16. Recently, the relationship between dysbiosis and NAFLD/NASH has been
revealed. The composition of the intestinal microbiota in NASH patients is different from healthy
individual17. Among NAFLD patients, differences in the intestinal microbiota have been reported
between patients with NAFL and NASH as well as between severe and mild/moderate fibrosis18,19. ...

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Acknowledgements

I am grateful to many people who supported me, so that I was able to start my doctoral study and

continue my all research. First of all, I would like to thank the people who strongly supported me.

I would like to express my deepest gratitude to Professor Emeritus Tokiyoshi Ayabe for invaluable

advice and guidance throughout all of my research activities. I thank for his great patience and guiding

me to the appropriate way to reach my final goal.

I sincerely and deeply appreciate Professor Kiminori Nakamura for teaching me the fundamentals of

all experimental methods, ways of thinking, and attitudes toward research. I thank for devoting a great

deal of his time, intelligence, and emotional support to me a lot. I also deeply appreciate Assistant

Professor Yuki Yokoi and Dr. Yu Shimizu in the Innate Immunity Laboratory for courteous guidance

and support throughout my research.

I would like to thank Professor Tomoyasu Aizawa for continuous support of my research as an

important collaborator as well as the associate examiner of the thesis. I also thank Associate Professor

Ryota Uehara for supporting my research as associate examiner of the thesis. I sincerely appreciate

Professor Andre J Ouellette at Kech School of Medicine in University of Southern California for

precise advice and constructive discussions. I would like to thank Ms. Aiko Kuroishi and Ms. Mutsuko

Tanaka who provided enormous technical support. I thank Ms. Mari Tatsumi who has always helped

me in my entire laboratory life. Finally, I gratitude to all the laboratory members for their support in

continuing and accomplishing this work.

57

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