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This research was funded in part supported by "Istituto Toscano Tumori" (ITT), the University of Florence and Regione Toscana "Ricerca Regionale in materia di salute D.D. n. 3242" (M.P.). This work was in part supported by Royal Free Charity and UCL NIHR Biomedical Research Centre (M.P. and K.R.). R.B. is supported by NIH/NIAAA grants AA026972, AA026978, and AA026264 and NIDDK grant P30DK120531.

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Fondevila, ConstantinoAuthor

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March 29, 2023
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Exogenous Liposomal Ceramide-C6 Ameliorates Lipidomic Profile, Energy Homeostasis, and Anti-Oxidant Systems in NASH

Publicated to:Cells. 9 (5): - 2020-05-01 9(5), DOI: 10.3390/cells9051237

Authors: Zanieri, Francesca; Levi, Ana; Montefusco, David; Longato, Lisa; De Chiara, Francesco; Frenguelli, Luca; Omenetti, Sara; Andreola, Fausto; Tu Vinh Luong; Massey, Veronica; Caballeria, Juan; Fondevila, Constantino; Shanmugavelandy, Sriram S.; Fox, Todd; Mazza, Giuseppe; Argemi, Josepmaria; Bataller, Ramon; Cowart, Lauren Ashley; Kester, Mark; Pinzani, Massimo; Rombouts, Krista;

Affiliations

Hosp Clin Barcelona, Hepatol, IDIBAPS, CIBERehd, Barcelona 08036, Spain - Author
Hunter Holmes McGuire VA Med Ctr, Richmond, VA 23219 USA - Author
Penn State Univ, Coll Med, Dept Pharmacol, Hershey, PA 17033 USA - Author
Royal Free Hosp, Dept Cellular Pathol, London NW3 2PF, England - Author
Royal Free London NHS Fdn Trust, Sheila Sherlock Liver Ctr, London NW3 2PF, England - Author
Royal Free Univ Coll London UCL, Inst Liver & Digest Hlth, London NW3 2PF, England - Author
Univ Barcelona, Hosp Clin, Dept Surg, Liver Transplant Unit, Barcelona 08036, Spain - Author
Univ Florence, Ctr Excellence DENOthe, I-50134 Florence, Italy - Author
Univ Florence, Dept Expt & Clin Med, I-50134 Florence, Italy - Author
Univ N Carolina, Div Hepatol & Gastroenterol, Dept Med, Chapel Hill, NC 27599 USA - Author
Univ N Carolina, Div Hepatol & Gastroenterol, Dept Nutr, Chapel Hill, NC 27599 USA - Author
Univ Pittsburgh, Dept Med, Pittsburgh Liver Res Ctr, Pittsburgh, PA 15261 USA - Author
Univ Virginia, Sch Med, Dept Pharmacol, POB 800735, Charlottesville, VA 22908 USA - Author
Virginia Commonwealth Univ, Richmond, VA 23219 USA - Author
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Abstract

In non-alcoholic steatohepatitis (NASH), many lines of investigation have reported a dysregulation in lipid homeostasis, leading to intrahepatic lipid accumulation. Recently, the role of dysfunctional sphingolipid metabolism has also been proposed. Human and animal models of NASH have been associated with elevated levels of long chain ceramides and pro-apoptotic sphingolipid metabolites, implicated in regulating fatty acid oxidation and inflammation. Importantly, inhibition of de novo ceramide biosynthesis or knock-down of ceramide synthases reverse some of the pathology of NASH. In contrast, cell permeable, short chain ceramides have shown anti-inflammatory actions in multiple models of inflammatory disease. Here, we investigated non-apoptotic doses of a liposome containing short chain C6-Ceramide (Lip-C6) administered to human hepatic stellate cells (hHSC), a key effector of hepatic fibrogenesis, and an animal model characterized by inflammation and elevated liver fat content. On the basis of the results from unbiased liver transcriptomic studies from non-alcoholic fatty liver disease patients, we chose to focus on adenosine monophosphate activated kinase (AMPK) and nuclear factor-erythroid 2-related factor (Nrf2) signaling pathways, which showed an abnormal profile. Lip-C6 administration inhibited hHSC proliferation while improving anti-oxidant protection and energy homeostasis, as indicated by upregulation of Nrf2, activation of AMPK and an increase in ATP. To confirm these in vitro data, we investigated the effect of a single tail-vein injection of Lip-C6 in the methionine-choline deficient (MCD) diet mouse model. Lip-C6, but not control liposomes, upregulated phospho-AMPK, without inducing liver toxicity, apoptosis, or exacerbating inflammatory signaling pathways. Alluding to mechanism, mass spectrometry lipidomics showed that Lip-C6-treatment reversed the imbalance in hepatic phosphatidylcholines and diacylglycerides species induced by the MCD-fed diet. These results reveal that short-term Lip-C6 administration reverses energy/metabolic depletion and increases protective anti-oxidant signaling pathways, possibly by restoring homeostatic lipid function in a model of liver inflammation with fat accumulation.

Keywords

adenosine monophosphate-activated kinase (ampk)apoptosisceramidesdiacylglycerol (dg)human hepatic stellate cells (hhsc)inflammationlipidomicsliposomesmethionine-choline deficient diet (mcd)non-alcoholic steatohepatitis (nash)nuclear factor-erythroid 2-related factor 2 (nfe2l2/nrf2)ActivationAdenosine monophosphate-activated kinase (ampk)AmpkAnimal-modelsApoptosisCeramidesDeliveryDiacylglycerol (dg)Fatty liver-diseaseHepatic stellate cellsHuman hepatic stellate cells (hhsc)InflammationInhibitionLipidomicsLiposomesMethionine-choline deficient diet (mcd)Non-alcoholic steatohepatitis (nash)Nonalcoholic steatohepatitisNrf2)Nuclear factor-erythroid 2-related factor 2 (nfe2l2Phosphatidylcholine (pc)Short-chainUnfolded protein response

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Cells due to its progression and the good impact it has achieved in recent years, according to the agency Scopus (SJR), it has become a reference in its field. In the year of publication of the work, 2020, it was in position , thus managing to position itself as a Q1 (Primer Cuartil), in the category Medicine (Miscellaneous).

From a relative perspective, and based on the normalized impact indicator calculated from the Field Citation Ratio (FCR) of the Dimensions source, it yields a value of: 2.51, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: Dimensions Aug 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-08-29, the following number of citations:

  • WoS: 12

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-08-29:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 28.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 28 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 0.25.
  • The number of mentions on the social network X (formerly Twitter): 1 (Altmetric).

Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: Italy; United Kingdom; United States of America.