Hedgehog signaling pathway activation has been implicated in the pathogenesis of NASH. Despite this concept, hedgehog pathway inhibitors have not been explored. Thus, we examined the effect of
vismodegib, a hedgehog signaling pathway inhibitor, in a diet-induced model of NASH. C57BL/6 mice were placed on 3-month chow or FFC (high saturated
fats,
fructose, and
cholesterol) diet. One week prior to sacrifice, mice were treated with
vismodegib or vehicle. Mice fed the FFC diet developed significant steatosis, which was unchanged by
vismodegib therapy. In contrast,
vismodegib significantly attenuated FFC-induced liver injury as manifested by reduced serum ALT and hepatic TUNEL-positive cells. In line with the decreased apoptosis,
vismodegib prevented FFC-induced strong upregulation of
death receptor DR5 and its
ligand TRAIL. In addition, FFC-fed mice, but not chow-fed animals, underwent significant liver injury and apoptosis following treatment with a DR5 agonist; however, this injury was prevented by pre-treatment with
vismodegib. Consistent with a reduction in liver injury,
vismodegib normalized FFC-induced markers of
inflammation including
mRNA for TNF-α, IL-1β,
IL-6,
monocyte chemotactic protein-1 and a variety of macrophage markers. Furthermore,
vismodegib in FFC-fed mice abrogated indices of hepatic fibrogenesis. In conclusion, inhibition of hedgehog signaling with
vismodegib appears to reduce TRAIL-mediated liver injury in a nutrient excess model of NASH, thereby attenuating hepatic
inflammation and
fibrosis. We speculate that hedgehog signaling inhibition may be salutary in human NASH.