The DOI matches its Crossref record; 41 of the 41 references it cites were found in a registry or an index.
Inflammasome-mediated dysbiosis regulates progression of NAFLD and obesity
Open accessAbstract
Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of metabolic syndrome and the leading cause of chronic liver disease in the Western world. Twenty per cent of NAFLD individuals develop chronic hepatic inflammation (non-alcoholic steatohepatitis, NASH) associated with cirrhosis, portal hypertension and hepatocellular carcinoma, yet the causes of progression from NAFLD to NASH remain obscure. Here, we show that the NLRP6 and NLRP3 inflammasomes and the effector protein IL-18 negatively regulate NAFLD/NASH progression, as well as multiple aspects of metabolic syndrome via modulation of the gut microbiota. Different mouse models reveal that inflammasome-deficiency-associated changes in the configuration of the gut microbiota are associated with exacerbated hepatic steatosis and inflammation through influx of TLR4 and TLR9 agonists into the portal circulation, leading to enhanced hepatic tumour-necrosis factor (TNF)-α expression that drives NASH progression. Furthermore, co-housing of inflammasome-deficient mice with wild-type mice results in exacerbation of hepatic steatosis and obesity. Thus, altered interactions between the gut microbiota and the host, produced by defective NLRP3 and NLRP6 inflammasome sensing, may govern the rate of progression of multiple metabolic syndrome-associated abnormalities, highlighting the central role of the microbiota in the pathogenesis of heretofore seemingly unrelated systemic auto-inflammatory and metabolic disorders.
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In the citing paper
“LPS-mediated activation of KCs via TLR4 leading to MyD88-dependent activation of NF-kB, production of proinflammatory cytokines and subsequent liver injury have also been demonstrated for both MASH(214) and ASH(215).”
From The liver as a central "hub" of the immune system: pathophysiological implications (2025) · cites this paper as [214]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Animal studies have demonstrated a direct role of altered intestinal microbiota in steatosis,15 NASH(16), fibrosis17 and liver cancer.18”
From Intestinal B cells license metabolic T-cell activation in NASH microbiota/antigen-independently and contribute to fibrosis by IgA-FcR signalling (2023) · cites this paper as [16]
In the citing paper
“In NAFLD models, lack of inflammasomes has been demonstrated to select a pathogenetic microbiota which was associated with a more severe degree of liver injury [226].”
From Gut-pancreas-liver Axis as a target for treatment of NAFLD/NASH (2020) · cites this paper as [226]
In the citing paper
“Either in patients with NASH or animal models, the expression of inflammasome components was increased, indicating the potential role in the pathogenesis of liver injury [226,227,288,289,290,291].”
From Gut-pancreas-liver Axis as a target for treatment of NAFLD/NASH (2020) · cites this paper as [226]
In the citing paper
“These results indicate that complex interactions between the diet, the innate immunity, bacteria and intestinal function occurs in the development of NASH [226,227], and similar observations were obtained in experimental models of HCC development [285,286,287].”
From Gut-pancreas-liver Axis as a target for treatment of NAFLD/NASH (2020) · cites this paper as [226]
In the citing paper
“Co-housing wildtype mice with mice prone to MASH led to increased disease severity in wildtype mice, presumably due to a transfer of fecal microbiota (204).”
From Found in translation—Fibrosis in metabolic dysfunction–associated steatohepatitis (MASH) (2023) · cites this paper as [204]
In the citing paper
“In the MCD diet model, the microbiota has a key role in NASH exacerbation as demonstrated by experiments, in which co-housing transmitted NASH risk and antibiotics reduced NASH risk65.”
From The gut microbiome and liver cancer: mechanisms and clinical translation (2017) · cites this paper as [65]
In the citing paper
“Functional studies utilizing co-housing and faecal transplantation have provided evidence that dysbiosis is a transmissible driver of liver disease development and progression 65,89.”
From The gut microbiome and liver cancer: mechanisms and clinical translation (2017) · cites this paper as [65]
In the citing paper
“Similarly, dysbiosis represented a transmissible risk factor in a genetic NASH model in which NASH was triggered by inflammasome deficiency; co-housing of dysbiotic inflammasome-deficient mice with control mice resulted in the development of NASH in control mice65.”
From The gut microbiome and liver cancer: mechanisms and clinical translation (2017) · cites this paper as [65]
In the citing paper
“Association of bacterial composition with many diseases has been observed, including immune, inflammatory, and metabolic phenotypes.”
From The Gut Microbiome Contributes to a Substantial Proportion of the Variation in Blood Lipids (2015) · cites this paper as [5]
In the citing paper
“Disruption of the murine inflammasomes (see box 1) is associated with an increase in Bacteroidetes and reduction in Firmicutes and results in severe hepatic steatosis and inflammation.41”
From The gut microbiota and host health: a new clinical frontier (2016) · cites this paper as [41]
In the citing paper
“the NLRP6 and NLRP3 inflammasomes may exert protective effects against NAFLD/NASH through modulation of the gut microbiota.181”
From Interaction between microbiota and immunity in health and disease (2020) · cites this paper as [181]
In the citing paper
“Dysbiosis has been observed in mice deficient for inflammasomes components, including NLRP6, ASC, caspase-1, and IL-18 [131,132,133,134].”
From Gut Microbiota and Cancer: From Pathogenesis to Therapy (2019) · cites this paper as [134]
In the citing paper
“The Muc2-KO mouse possesses a distinct gut-associated bacterial community that is influenced by its altered genetic and immune states, as has been shown in other genetic knockout mouse models.4,53–55”
From Using Corticosteroids to Reshape the Gut Microbiome: Implications for Inflammatory Bowel Diseases (2015) · cites this paper as [54]
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Citations
Cites
QIIME allows analysis of high-throughput community sequencing data
Caporaso, J. G., Kuczynski, J., Stombaugh, J., Bittinger, K., Bushman, F. D., Costello, E. K., Fierer, N., Peña, A. G., Goodrich, J. K., Gordon, J. I., et al. (2010) · Nature Methods · doi:10.1038/nmeth.f.303 · Cited by 34,887
Self-citationDesign and validation of a histological scoring system for nonalcoholic fatty liver disease†
Kleiner, D. E., Brunt, E. M., Van Natta, M., Behling, C., Contos, M. J., Cummings, O. W., Ferrell, L. D., Liu, Y., Torbenson, M. S., Unalp‐Arida, A., et al. (2005) · Hepatology · doi:10.1002/hep.20701 · Cited by 10,791
A Toll-like receptor recognizes bacterial DNA
Hemmi, H., Takeuchi, O., Kawai, T., Kaisho, T., Sato, S., Sanjo, H., Matsumoto, M., Hoshino, K., Wagner, H., Takeda, K., et al. (2000) · Nature · doi:10.1038/35047123 · Cited by 6,491 · cited 1×
“Tlr9 –/– mice have been described in another repor”
BackgroundMartinon, F., Burns, K., & Tschopp, J. (2002) · Molecular Cell · doi:10.1016/s1097-2765(02)00599-3 · Cited by 6,066
A role for mitochondria in nlrp3 inflammasome activation
Zhou, R., Yazdi, A. S., Menu, P., & Tschopp, J. (2011) · Nature · doi:10.1038/nature09663 · Cited by 5,602
Steatohepatitis: A tale of two “hits”?
Day, C. P., & James, O. F. W. (1998) · Gastroenterology · doi:10.1016/s0016-5085(98)70599-2 · Cited by 4,285
NLRP3 inflammasomes are required for atherogenesis and activated by cholesterol crystals
Duewell, P., Kono, H., Rayner, K. J., Sirois, C. M., Vladimer, G., Bauernfeind, F. G., Abela, G. S., Franchi, L., Nuñez, G., Schnurr, M., et al. (2010) · Nature · doi:10.1038/nature08938 · Cited by 4,026
Ludwig, J., Viggiano, T. R., McGill, D. B., & Ott, B. J. (1980) · Mayo Clinic Proceedings · doi:10.1016/s0025-6196(24)00530-5 · Cited by 2,903
Nonalcoholic Fatty Liver, Steatohepatitis, and the Metabolic Syndrome
Marchesini, G., Bugianesi, E., Forlani, G., Cerrelli, F., Lenzi, M., Manini, R., Natale, S., Vanni, E., Villanova, N., Melchionda, N., et al. (2003) · Hepatology · doi:10.1053/jhep.2003.50161 · Cited by 2,728
Thioredoxin-interacting protein links oxidative stress to inflammasome activation
Zhou, R., Tardivel, A., Thorens, B., Choi, I., & Tschopp, J. (2010) · Nature Immunology · doi:10.1038/ni.1831 · Cited by 2,708
The NLRP3 inflammasome instigates obesity-induced inflammation and insulin resistance
Vandanmagsar, B., Youm, Y.-H., Ravussin, A., Galgani, J. E., Stadler, K., Mynatt, R. L., Ravussin, E., Stephens, J. M., & Dixit, V. D. (2011) · Nature Medicine · doi:10.1038/nm.2279 · Cited by 2,655
Nonalcoholic steatohepatitis: association of insulin resistance and mitochondrial abnormalities
Sanyal, A. J., Campbell–Sargent, C., Mirshahi, F., Rizzo, W. B., Contos, M. J., Sterling, R. K., Luketic, V. A., Shiffman, M. L., & Clore, J. N. (2001) · Gastroenterology · doi:10.1053/gast.2001.23256 · Cited by 2,078
NLRP6 Inflammasome Regulates Colonic Microbial Ecology and Risk for Colitis
Elinav, E., Strowig, T., Kau, A. L., Henao-Mejia, J., Thaiss, C. A., Booth, C. J., Peaper, D. R., Bertin, J., Eisenbarth, S. C., Gordon, J. I., et al. (2011) · Cell · doi:10.1016/j.cell.2011.04.022 · Cited by 2,024
Self-citationTLR4 enhances TGF-β signaling and hepatic fibrosis
Seki, E., De Minicis, S., Österreicher, C. H., Kluwe, J., Osawa, Y., Brenner, D. A., & Schwabe, R. F. (2007) · Nature Medicine · doi:10.1038/nm1663 · Cited by 1,942
Agostini, L., Martinon, F., Burns, K., McDermott, M. F., Hawkins, P. N., & Tschopp, J. (2004) · Immunity · doi:10.1016/s1074-7613(04)00046-9 · Cited by 1,768
Fatty acid–induced NLRP3-ASC inflammasome activation interferes with insulin signaling
Wen, H., Gris, D., Lei, Y., Jha, S., Zhang, L., Huang, M. T.-H., Brickey, W. J., & Ting, J. P.-Y. (2011) · Nature Immunology · doi:10.1038/ni.2022 · Cited by 1,698
Masters, S. L., Dunne, A., Subramanian, S. L., Hull, R. L., Tannahill, G. M., Sharp, F. A., Becker, C., Franchi, L., Yoshihara, E., Chen, Z., et al. (2010) · Nature Immunology · doi:10.1038/ni.1935 · Cited by 1,330
Cryptogenic Cirrhosis: Clinical Characterization and Risk Factors for Underlying Disease
Caldwell, S. H., Oelsner, D. H., Iezzoni, J. C., Hespenheide, E. E., Battle, E. H., & Driscoll, C. J. (1999) · Hepatology · doi:10.1002/hep.510290347 · Cited by 1,138
Sutterwala, F. S., Ogura, Y., Szczepanik, M., Lara-Tejero, M., Lichtenberger, G. S., Grant, E. P., Bertin, J., Coyle, A. J., Galán, J. E., Askenase, P. W., et al. (2006) · Immunity · doi:10.1016/j.immuni.2006.02.004 · Cited by 980
Self-citationLi, Z., Yang, S., Lin, H., Huang, J., Watkins, P. A., Moser, A. B., Desimone, C., Song, X.-Y., & Diehl, A. M. (2003) · Hepatology · doi:10.1053/jhep.2003.50048 · Cited by 930
Toll-Like Receptor 9 Promotes Steatohepatitis by Induction of Interleukin-1β in Mice
Miura, K., Kodama, Y., Inokuchi, S., Schnabl, B., Aoyama, T., Ohnishi, H., Olefsky, J. M., Brenner, D. A., & Seki, E. (2010) · Gastroenterology · doi:10.1053/j.gastro.2010.03.052 · Cited by 741
Inflammasome is a central player in the induction of obesity and insulin resistance
Stienstra, R., van Diepen, J. A., Tack, C. J., Zaki, M. H., van de Veerdonk, F. L., Perera, D., Neale, G. A., Hooiveld, G. J., Hijmans, A., Vroegrijk, I., et al. (2011) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1100255108 · Cited by 727
Crespo, J., Cayón, A., Fernández-Gil, P. L., Hernández‐Guerra, M., Mayorga, M., Domínguez‐Díez, A., Fernández-Escalante, J. C., & Pons‐Romero, F. (2001) · Hepatology · doi:10.1053/jhep.2001.29628 · Cited by 708
Rivera, C. A., Adegboyega, P., van Rooijen, N., Tagalicud, A., Allman, M., & Wallace, M. (2007) · Journal of Hepatology · doi:10.1016/j.jhep.2007.04.019 · Cited by 693
Linkage of gut microbiome with cognition in hepatic encephalopathy
Bajaj, J. S., Ridlon, J. M., Hylemon, P. B., Thacker, L. R., Heuman, D. M., Smith, S., Sikaroodi, M., & Gillevet, P. M. (2012) · American Journal of Physiology-Gastrointestinal and Liver Physiology · doi:10.1152/ajpgi.00190.2011 · Cited by 547
Sheth, S. G., Gordon, F. D., & Chopra, S. (1997) · Annals of Internal Medicine · doi:10.7326/0003-4819-126-2-199701150-00008 · Cited by 514
Deficiency of interleukin-18 in mice leads to hyperphagia, obesity and insulin resistance
Netea, M. G., Joosten, L. A. B., Lewis, E., Jensen, D. R., Voshol, P. J., Kullberg, B. J., Tack, C. J., van Krieken, H., Kim, S.-H., Stalenhoef, A. F., et al. (2006) · Nature Medicine · doi:10.1038/nm1415 · Cited by 424
Hepatocellular carcinoma in patients with non-alcoholic steatohepatitis
Shimada, M., Hashimoto, E., Taniai, M., Hasegawa, K., Okuda, H., Hayashi, N., Takasaki, K., & Ludwig, J. (2002) · Journal of Hepatology · doi:10.1016/s0168-8278(02)00099-5 · Cited by 356
Inflammasome-mediated disease animal models reveal roles for innate but not adaptive immunity
Brydges, S. D., Mueller, J. L., McGeough, M. D., Pena, C. A., Misaghi, A., Gandhi, C., Putnam, C. D., Boyle, D. L., Firestein, G. S., Horner, A. A., et al. (2009) · Immunity · doi:10.1016/j.immuni.2009.05.005 · Cited by 339
Self-citationGuebre‐Xabier, M., Yang, S., Lin, H. Z., Schwenk, R., Krzych, U., & Diehl, A. M. (2000) · Hepatology · doi:10.1002/hep.510310313 · Cited by 192
The inflammasome in pathogen recognition and inflammation
Sutterwala, F. S., Ogura, Y., & Flavell, R. A. (2007) · Journal of Leukocyte Biology · doi:10.1189/jlb.1206755 · Cited by 166
Self-citationLessons from animal models of NASH
Diehl, A. M. (2005) · Hepatology Research · doi:10.1016/j.hepres.2005.09.022 · Cited by 152
Makiura, N., Ojima, M., Kou, Y., Furuta, N., Okahashi, N., Shizukuishi, S., & Amano, A. (2008) · Oral Microbiology and Immunology · doi:10.1111/j.1399-302x.2007.00426.x · Cited by 128
Guo, X., Roberts, M. R., Becker, S. M., Podd, B. S., Zhang, Y., Chua, S. C., Myers, M. G., Duggal, P., Houpt, E. R., & Petri, W. A. (2010) · Mucosal Immunology · doi:10.1038/mi.2010.76 · Cited by 123
Non-alcoholic steatohepatitis and animal models: Understanding the human disease
Varela‐Rey, M., Embade, N., Ariz, U., Lu, S. C.-L., Mato, J. M., & Martínez‐Chantar, M. L. (2008) · The International Journal of Biochemistry & Cell Biology · doi:10.1016/j.biocel.2008.10.027 · Cited by 120
Gut flora and bacterial translocation in chronic liver disease
Almeida, J. A. (2006) · World Journal of Gastroenterology · doi:10.3748/wjg.v12.i10.1493 · Cited by 105
The role of leptin in progression of non-alcoholic fatty liver disease
Ikejima, K., Okumura, K., LANG, T., HONDA, H., Abe, W., Yamashina, S., ENOMOTO, N., TAKEI, Y., & Sato, N. (2005) · Hepatology Research · doi:10.1016/j.hepres.2005.09.024 · Cited by 86
Prognosis in nonalcoholic steatohepatitis
Propst, A., Propst, T., Judmaier, G., & Vogel, W. (1995) · Gastroenterology · doi:10.1016/0016-5085(95)90724-6 · Cited by 85
Cirrhosis and liver failure in nonalcoholic fatty liver disease: Molehill or mountain?
Charlton, M. (2008) · Hepatology · doi:10.1002/hep.22246 · Cited by 71
Broomé, U., Glaumann, H., & Hultcrantz, R. (1990) · Gut · doi:10.1136/gut.31.4.468 · Cited by 46
Nonalcoholic fatty liver disease.
Hjelkrem, M., Torres, D. M., & Harrison, S. A. (2008) · PubMed · Cited by 22
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Nicholson, J. K., Holmes, E., Kinross, J., Burcelin, R., Gibson, G., Jia, W., & Pettersson, S. (2012) · Science · doi:10.1126/science.1223813 · Cited by 4,760
Genetic studies of body mass index yield new insights for obesity biology
Study, T. L. C., Locke, A. E., The ADIPOGen Consortium, The AGEN-BMI Working Group, The CARDIOGRAMplusC4D Consortium, The CKDGen Consortium, The, G. L. G. C., The, I. C. B. P., The MAGIC Investigators, The MuTHER Consortium, et al. (2015) · Nature · doi:10.1038/nature14177 · Cited by 4,534
Functional interactions between the gut microbiota and host metabolism
Tremaroli, V., & Bäckhed, F. (2012) · Nature · doi:10.1038/nature11552 · Cited by 4,387
Mechanisms of NAFLD development and therapeutic strategies
Friedman, S. L., Neuschwander-Tetri, B. A., Rinella, M., & Sanyal, A. J. (2018) · Nature Medicine · doi:10.1038/s41591-018-0104-9 · Cited by 4,354
Interactions Between the Microbiota and the Immune System
Hooper, L. V., Littman, D. R., & Macpherson, A. J. (2012) · Science · doi:10.1126/science.1223490 · Cited by 4,173
Metadata
- Authors
- Henao-Mejia, J., Elinav, E., Jin, C., Hao, L., Mehal, W. Z., Strowig, T., Thaiss, C. A., Kau, A. L., Eisenbarth, S. C., Jurczak, M. J., Camporez, J.-P., Shulman, G. I., Gordon, J. I., Hoffman, H. M., & Flavell, R. A.
- Affiliations
- Yale University (US)
- Washington University in St. Louis (US)
- Howard Hughes Medical Institute (US)
- University of California San Diego (US)
- Corresponding author
- Flavell, Richard A.
- ORCID
- Venue
- Nature
- Published
- 2012-02
- Volume
- 482
- Issue
- 7384
- Pages
- 179-185
- ISSN
- 0028-0836 (ISSN-L)
- 1476-4687
- PMC
- PMC3276682
- OpenAlex
- W2144275312
- Cited by
- 2,435
- References
- 41
- Citations by year
- 2026: 83 · 2025: 103 · 2024: 137 · 2023: 165 · 2022: 158 · 2021: 182 · 2020: 215 · 2019: 188 · 2018: 197 · 2017: 184 · 2016: 172 · 2015: 195 · 2014: 181 · 2013: 185 · 2012: 85
- FWCI
- 154.13
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Funders
- Howard Hughes Medical Institute
- Crohn's and Colitis Foundation
- U.S. Public Health Service (K08A1085038)
- National Heart, Lung, and Blood Institute (T32HL007974)
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK45735, R01-DK40936, R01DK040936, U24DK059635, R01DK076674, R24DK085638, P30DK045735)
- Topics
- Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Inflammasome and immune disorders
- Keywords
- non-alcoholic fatty liver disease, nonalcoholic steatohepatitis, NLRP3 inflammasome, NLRP6 inflammasome, IL-18, gut dysbiosis, metabolic syndrome, obesity, hepatic steatosis, liver inflammation, TLR4, TLR9, TNF-α, Porphyromonadaceae, host-microbiota interactions, autoinflammatory disease
- MeSH terms
- NLR Family, Pyrin Domain-Containing 3 Protein, Animals, Carrier Proteins, Choline, Colon, Cytoskeletal Proteins, Disease Models, Animal, Fatty Liver, Inflammation, Male, Methionine, Mice, Inbred C57BL, Obesity, Receptors, Cell Surface, RNA, Ribosomal, 16S, Tumor Necrosis Factor-alpha, Disease Progression, Interleukin-18, Apoptosis Regulatory Proteins, Toll-Like Receptor 4, Toll-Like Receptor 9, Mice, CARD Signaling Adaptor Proteins, Metagenome, Inflammasomes, Non-alcoholic Fatty Liver Disease
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