The underlying mechanisms that perpetuate liver
inflammation in
nonalcoholic steatohepatitis are poorly understood. We explored the hypothesis that
cyclooxygenase-2 (COX-2) can exert pro-inflammatory effects in metabolic forms of
fatty liver disease. Male wild-type (WT) C57BL6/N or
peroxisome proliferator-activated receptor alpha knockout (
PPAR-alpha-/-) mice were fed a lipogenic,
methionine- and
choline-deficient (MCD) diet or the same diet with supplementary
methionine and
choline (control). COX-2 was not expressed in livers of mice fed the control diet. In mice fed the MCD diet, hepatic expression of COX-2
messenger RNA and
protein occurred from day 5, continued to rise, and was 10-fold higher than controls after 5 weeks, thereby paralleling the development of
steatohepatitis. Upregulation of COX-2 was even more pronounced in
PPAR-alpha-/- mice. Induction of COX-2 was completely prevented by dietary supplementation with the potent
PPAR-alpha agonist
Wy-14,643 in WT but not
PPAR-alpha-/- mice. COX-2 upregulation was preceded by activation of
nuclear factor kappaB (
NF-kappaB) and coincided with increased levels of
tumor necrosis factor alpha (
TNF-alpha),
interleukin (IL)-6, and
intercellular adhesion molecule 1 (ICAM-1). Selective
COX-2 inhibitors (
celecoxib and
NS-398) protected against the development of
steatohepatitis in WT but not
PPAR-alpha-/- mice. In conclusion, induction of COX-2 occurs in association with
NF-kappaB activation and upregulation of
TNF-alpha,
IL-6, and
ICAM-1 in MCD diet-induced
steatohepatitis.
PPAR-alpha suppresses both COX-2 and development of
steatohepatitis, while pharmacological inhibition of COX-2 activity ameliorates the severity of experimental
steatohepatitis. COX-2 may therefore be a pro-inflammatory mediator in metabolic forms of
steatohepatitis.