Impaired endothelial autophagy promotes liver fibrosis by aggravating the oxidative stress response during acute liver injury

Maria Ruart, Laia Chavarria, Genís Campreciós, Nuria Suárez-Herrera, Carla Montironi, Sergi Guixé-Muntet, Jaume Bosch, Scott L. Friedman, Juan Carlos Garcia-Pagán, Virginia Hernández-Gea

Research output: Contribution to journalArticlepeer-review

141 Scopus citations


Background & Aims: Endothelial dysfunction plays an essential role in liver injury, yet the phenotypic regulation of liver sinusoidal endothelial cells (LSECs) remains unknown. Autophagy is an endogenous protective system whose loss could undermine LSEC integrity and phenotype. The aim of our study was to investigate the role of autophagy in the regulation of endothelial dysfunction and the impact of its manipulation during liver injury. Methods: We analyzed primary isolated LSECs from Atg7control and Atg7endo mice as well as rats after CCl4 induced liver injury. Liver tissue and primary isolated stellate cells were used to analyze liver fibrosis. Autophagy flux, microvascular function, nitric oxide bioavailability, cellular superoxide content and the antioxidant response were evaluated in endothelial cells. Results: Autophagy maintains LSEC homeostasis and is rapidly upregulated during capillarization in vitro and in vivo. Pharmacological and genetic downregulation of endothelial autophagy increases oxidative stress in vitro. During liver injury in vivo, the selective loss of endothelial autophagy leads to cellular dysfunction and reduced intrahepatic nitric oxide. The loss of autophagy also impairs LSECs ability to handle oxidative stress and aggravates fibrosis. Conclusions: Autophagy contributes to maintaining endothelial phenotype and protecting LSECs from oxidative stress during early phases of liver disease. Selectively potentiating autophagy in LSECs during early stages of liver disease may be an attractive approach to modify the disease course and prevent fibrosis progression. Lay summary: Liver endothelial cells are the first liver cell type affected after any kind of liver injury. The loss of their unique phenotype during injury amplifies liver damage by orchestrating the response of the liver microenvironment. Autophagy is a mechanism involved in the regulation of this initial response and its manipulation can modify the progression of liver damage.

Original languageEnglish
Pages (from-to)458-469
Number of pages12
JournalJournal of Hepatology
Issue number3
StatePublished - Mar 2019


  • Atg7
  • Autophagy
  • Endothelial cell
  • Endothelial dysfunction
  • LSEC
  • Liver fibrosis
  • Nitric oxide
  • Nrf2
  • Oxidative stress
  • eNOS


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