Targeting miR-144 a promising therapeutic strategy for the treatment of liver diseases in obese patients


Nonalcoholic fatty liver disease is caused by the organ’s inability to process excessive lipid. It can be attributed to a lowering of fat storage capacity in the body’s adipose tissue. But what’s happening on the cellular and molecular levels in livers?

Researchers at Karolinska Institute in Sweden led by professor Myriam Aouadi found that immune cells; liver macrophages contribute to the organ’s response to lipid accumulation. Silencing the RNA molecule miR-144 could restore the normal function of the immune cells in mice, they showed in a new study published in Science Translational Medicine. Because miR-144 is also upregulated in the liver of obese insulin-resistant individuals who are at high risk of developing fatty liver disease, the team suggests the findings could lead to new strategies for treating the condition in humans.

When obesity causes changes in the body’s adipose tissue, fatty acids are instead delivered to the liver. As a protective response, liver macrophages try to break down this unwanted lipid accumulation, and, in the process, they produce excessive oxidants that can damage the liver, the team demonstrated in obese mice fed a high-fat diet. The same thing happens in humans.

Oxidative stress is known to trigger an antioxidant response regulated by the expression of transcription factor Nrf2. But in both obese mice and humans, scientists have observed significantly reduced levels of the Nrf2 protein in the liver macrophages.

Nrf2 is an important transcription factor that controls many detoxifying or anti-inflammatory defense mechanisms. It is indeed a valuable therapeutic target for several pharmaceutical companies such as Reata Pharmaceuticals who are developing several Nrf2 activators. Its lead project, omaveloxolone, recently succeeded in a pivotal clinical trial in Friedreich’s ataxia, an inherited degenerative neuromuscular disorder.

Under normal conditions, Nrf2 levels stay low because of a repressor called Keap1. University College London scientists previously reported that targeting Keap1 to increase Nrf2 activity could hold promise as a therapeutic strategy against Alzheimer’s disease, demonstrating that such a strategy could protect mouse neurons from amyloid-beta plaques.

However, in obesity-associated liver samples, they found that Keap1-induced degradation may not be related to a decrease in Nrf2 in liver macrophages, because Keap1 expression is unchanged during obesity. So they went on to investigate whether microRNAs, which are small non-coding RNA molecules, affect Nrf2 after transcription.

They found that miR-144 expression spikes in the livers of obese mice and obese insulin-resistant people. Both the immune cells and hepatocytes produce more miR-144. They observed the increase only in the liver, as its expression remained unchanged in other organs. To further investigate the role of miR-144, the researchers silenced it specifically in liver macrophages. They observed a significant increase of Nrf2 in the livers of obese mice, which led to reduced oxidative stress and restored metabolic functioning of the liver.

The research team argued that targeting liver macrophages miR-144 specifically to lower the burden of oxidative stress during obesity could offer a new strategy for tackling chronic liver diseases.

The authors believe that targeting miR-144 to increase the endogenous antioxidant response represents a promising therapeutic strategy for the treatment of liver diseases in obese patients including non-alcoholic steatohepatitis which is becoming a major cause of liver cancer worldwide and currently has no pharmacological treatment.

Targeting miR-144 a promising therapeutic strategy for the treatment of liver diseases in obese patients - Medicine Innovates

About the author

Myriam Aouadi

PhD, Group leader

I received my PhD in June 2006 from the University of Nice Sophia-Antipolis, France, in the laboratory of Yannick Le Marchand-Brustel. My worked focussed on the role of MAPK pathways in the commitment of embryonic stem cells in different lineages. I found that p38MAPK is an important player in the early steps of neurogenesis and myogenesis, while it is required for the late stages of adipogenesis. In 2006, I joined the laboratory of Michael Czech at the University of Massachusetts to work on the emerging field of immunometabolism, that investigates the interactions between immune and metabolic cells. During my postdoctoral studies, I developed a method to deliver siRNA specifically to macrophages in vivo. This unique technology allows the study of particular factors expressed by macrophages specifically. In 2009, I became assistant professor at the University of Massachusetts and used this novel technology to show that while macrophages in the adipose tissue could be detrimental to insulin sensitivity they could be beneficial as well.

My lab investigates the multiple roles and heterogeneity of liver and adipose tissue macrophages in metabolic diseases.


Azzimato V, Jager J, Chen P, Morgantini C, Levi L, Barreby E , Sulen A, Oses C , Willerbrords J, Xu C, Li X , Shen JX , Akbar N, Haag L, Ellis E, Wålhen K, Näslund E, Thorell A, Choudhury RP, Lauschke VM, Rydén M, Craige SM, Aouadi M. Liver macrophages inhibit the endogenous antioxidant response in obesity-associated insulin resistance. Science Translational Medicine. 2020;12(532). pii: eaaw9709. doi: 10.1126/scitranslmed.aaw9709.

Go To Science Translational Medicine