Nat Commun. 2026 07 25. pii: 9071. [Epub ahead of print]17(1):
Xiao Wen,
Keyan Wu,
Mengyao Wang,
Zihan Ma,
Tao Wang,
Jing Zhang,
Bei Wang,
Siyuan Chen,
Jingyi Wang,
Siyue Chen,
Fan Yang,
Chuwei Liu,
Xianyang Chen,
Lu Deng,
Yafan Cheng,
Qing Robert Miao,
Baofa Sun,
Xiongzhong Ruan,
Kai Li,
Yajun Duan,
Wenquan Hu.
Inflammation is a pivotal driver of the progression from metabolic dysfunction-associated steatotic liver disease (MASLD) to metabolic dysfunction-associated steatohepatitis (MASH), an aggressive form associated with substantial liver-related mortality. However, the molecular mechanisms underlying the initiation and persistence of liver inflammation remain poorly defined. Here, we demonstrated a previously unrecognized role for hepatic acetyl-CoA synthetase short-chain family member 2 (ACSS2) in MASH, showing that ACSS2 upregulation in patients exacerbates MASH progression by functioning as an epigenetic regulator, independent of its canonical lipogenic role. Mechanistically, ACSS2, in complex with lysine acetyltransferase 5 (KAT5), upregulates allograft inflammatory factor-1 (AIF1) transcription via histone crotonylation, thereby inducing liver inflammation and subsequently resulting in the aberrant accumulation of senescent hepatocytes, which further enhances proinflammatory cytokine production. This ultimately initiates a vicious cycle of chronic inflammation, which directly promotes the progression from simple steatosis to MASH. Thus, our work reveals a mechanistically defined and pivotal role for ACSS2 in promoting the MASLD-to-MASH transition, highlighting its potential as a compelling therapeutic target.