J Hepatol. 2022 Aug 16. pii: S0168-8278(22)02993-2. [Epub ahead of print]
Victoria Brandel,
Vanessa Schimek,
Samantha Göber,
Thomas Hammond,
Laura Brunnthaler,
Waltraud Cornelia Schrottmaier,
Marion Mussbacher,
Monika Sachet,
Ying Yu Liang,
Siegfried Reipert,
Gregor Ortmayr,
David Pereyra,
Jonas Santol,
Marlene Rainer,
Natalie Walterskirchen,
Cristiano Ramos,
Vasileios Gerakopoulos,
Carina Rainer,
Andreas Spittler,
Tamara Weiss,
Renate Kain,
Barbara Messner,
Thomas Gruenberger,
Alice Assinger,
Rudolf Oehler,
Patrick Starlinger.
BACKGROUND AND AIMS: Surgical resection of the cancerous tissue represents one of the few curative treatment options for neoplastic liver disease. Such partial hepatectomy (PHx) induces hepatocyte hyperplasia to restore liver function. PHx is associated with bacterial translocation, leading to an immediate immune response involving neutrophils and macrophages, which are indispensable for the priming phase of liver regeneration. Additionally, PHx induces longer-lasting intrahepatic apoptosis. Here, we investigated the effect of apoptotic extracellular vesicles (aEVs) on neutrophil function and their role in this later phase of liver regeneration.METHODS: A total of 124 patients undergoing PHx were included in this study. Blood levels of the apoptosis marker caspase-cleaved cytokeratin-18 (M30) and circulating aEVs were analyzed pre-operatively and on the first and fifth post-operative days. Additionally, the in vitro effects of aEVs on the neutrophil secretome, phenotype and functions were investigated.
RESULTS: Circulating aEVs increased at the first postoperative day. This was associated with higher concentrations of M30, which was only observed in patients with complete liver recovery. Efferocytosis of aEVs by neutrophils induced an activated phenotype (CD11bhighCD16highCD66bhighCD62Llow), however, classical inflammatory responses such as NETosis, respiratory burst, degranulation, or secretion of pro-inflammatory cytokines could not be observed. Instead, efferocytosing neutrophils released various growth factors including fibroblast growth factor-2 and hepatocyte growth factor (HGF). Accordingly, we observed an increase of HGF+ neutrophils after PHx and a correlation of plasma HGF with M30 levels.
CONCLUSIONS: These data suggest that the clearance of PHx-induced aEVs leads to a population of non-inflammatory, but regenerative neutrophils, which may support human liver regeneration.
LAY SUMMARY: In this study, we could show that partial hepatectomy induces apoptosis in the residual liver tissue. This results in the release of apoptotic vesicles into the blood flow, where they are cleared by circulating neutrophils, which respond by secreting hepatocyte growth factors and thus might support liver regeneration.
Keywords: Apoptosis; Extracellular Vesicles; Hepatectomy; Liver Regeneration; Neutrophils