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Lcn2 elevation has been shown to be closely associated with the development of alcoholic fatty liver disease (AFLD) in mice. To further understand the functional significance of the Lcn2 induction, we performed experiments utilizing in vitro cell culture and in vivo animal models of AFLD. In mouse AML-12 hepatocytes, ethanol exposure led to significantly induced activity of Lcn2 promoter and an increase in Lcn2 mRNA and protein expression; however these effects were completely blocked by pre-treatment of known inhibitors of nuclear transcription factor (NF-κB) and nuclear factor of activated T cells c4 (NFATc4), respectively. Remarkably, knockdown of miR-217 or overexpression of sir-tuin 1 (SIRT1) in hepatocytes or mouse liver largely abolished

the ability of ethanol to induce Lcn2, suggesting the involvement of miR-217-SIRT1 axis in mediating the effect of ethanol on Lcn2. We further discovered that adenovirus-mediated overex-pression of Lcn2 in the hepatocytes or mouse liver significantly deteriorated fatty liver injury in correlation with impairment of hepatic fatty acid oxidation by disrupting hepatic SIRT1-lipin-1 signaling. On the contrary, fatty liver injury was markedly attenuated by knocking down Lcn2 in hepatocytes exposed to ethanol or in liver specific Lcn2 knockout mice challenged with ethanol, providing a causal link between elevated Lcn2 levels and AFLD. Altogether, our findings suggest that Lcn2 is a pivotal regulator involved in devilment of alcoholic fatty liver. Hence, Lcn2 may represent a novel therapeutic target VX-765 clinical trial for treatment of human alcoholic fatty liver disease. Disclosures: The following people have

nothing to disclose: Alvin Jogasuria, Bin Gao, Min You Background: Challenges exist in staging, prognosis and treatment of nonalcoholic fatty liver disease (NAFLD). Identification of patients with nonalcoholic steatohepatitis (NASH) and significant fibrosis is critical, but hampered by the lack of accurate non-invasive biomarkers. We hypothesize that rare coding genetic variants control risk for liver fibrosis and progression in NAFLD. Our aim was to identify such rare genetic determinants of NASH and advanced fibrosis via whole exome sequencing. Methods: DNA Florfenicol samples from patients with biopsy proven NAFLD were sequenced using Illumina TruSeq and the HiSeq2000 protocol. A “protective” phenotype (n=20) was defined as patients with multiple risk factors for advanced hepatic fibrosis (age > 50 yrs, body mass index (BMI) >30 kg/m2, diabetes mellitus (DM)) and no hepatic fibrosis (F0). A “progressor” phenotype (n=26) was defined as patients without risk factors for advanced fibrosis (age < 55 yrs, BMI < 35 kg/m2, no DM) but with advanced fibrosis (F3 or F4). An additional comparison group consisted of 1,816 ancestry-matched population controls. Variants were tested for association using Fisher’s exact test.

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