Evidence map›Paper›PMID 35838051›Full record

ArticleThe Journal of clinical investigation2022

Distinct histopathological phenotypes of severe alcoholic hepatitis suggest different mechanisms driving liver injury and failure.

Jing Ma, Adrien Guillot, Zhihong Yang, Bryan Mackowiak, Seonghwan Hwang, Ogyi Park, Brandon J Peiffer, Ali Reza Ahmadi, Luma Melo, Praveen Kusumanchi and 13 more

Open access · goldAbstract read
In one paragraph

Article in The Journal of clinical investigation, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
54citing papers in PubMed, 2 pooled it
11.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

54 citing papers in PubMed, 2 syntheses or guidelines pooled it, 81 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. [Alcohol liver disease: immunoregulatory mechanisms and precision therapeutic targets].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026
    Review
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  10. Review
  11. Lipid Droplet Dynamics in Alcoholic Steatohepatitis.The American journal of pathology · 2026
    Review
  12. Article
  13. Review
  14. Review
  15. IgM Antibodies Targeting Malondialdehyde Promote Complement-Mediated Liver Injury in Alcohol-Related Liver Disease.Liver international : official journal of the International Association for the Study of the Liver · 2025
    Article
  16. Article
  17. Inflammation in MASLD progression and cancer.JHEP reports : innovation in hepatology · 2025
    Review
  18. Article
  19. Article
  20. Non-coding RNAs in alcohol-associated liver disease.Liver research (Beijing, China) · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors at 9 institutions in 3 countries.

Jing MaLaboratory of Liver Diseases, National Institute on Alcohol Abuse and Alcoholism (NIAAA), NIH, Bethesda, Maryland, USA.
Adrien GuillotLaboratory of Liver Diseases, National Institute on Alcohol Abuse and Alcoholism (NIAAA), NIH, Bethesda, Maryland, USA.
Zhihong YangDivision of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Bryan MackowiakLaboratory of Liver Diseases, National Institute on Alcohol Abuse and Alcoholism (NIAAA), NIH, Bethesda, Maryland, USA.
Seonghwan HwangLaboratory of Liver Diseases, National Institute on Alcohol Abuse and Alcoholism (NIAAA), NIH, Bethesda, Maryland, USA.
Ogyi ParkLaboratory of Liver Diseases, National Institute on Alcohol Abuse and Alcoholism (NIAAA), NIH, Bethesda, Maryland, USA.
Brandon J PeifferDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Ali Reza AhmadiDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Luma MeloCenter for Liver Diseases, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Praveen KusumanchiDivision of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Nazmul HudaDivision of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Romil SaxenaDepartment of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Yong HeLaboratory of Liver Diseases, National Institute on Alcohol Abuse and Alcoholism (NIAAA), NIH, Bethesda, Maryland, USA.
Yukun GuanLaboratory of Liver Diseases, National Institute on Alcohol Abuse and Alcoholism (NIAAA), NIH, Bethesda, Maryland, USA.
Dechun FengLaboratory of Liver Diseases, National Institute on Alcohol Abuse and Alcoholism (NIAAA), NIH, Bethesda, Maryland, USA.
Pau Sancho-BruInstitut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Barcelona, Spain.
Mengwei ZangDepartment of Molecular Medicine, Barshop Institute for Longevity and Aging Studies, Center for Healthy Aging, University of Texas Health San Antonio, San Antonio, Texas, USA.
Andrew MacGregor CameronDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Ramon BatallerCenter for Liver Diseases, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Frank TackeDepartment of Hepatology and Gastroenterology, Charité Universitätsmedizin Berlin, Campus Virchow-Klinikum and Campus Charité Mitte, Berlin, Germany.
Zhaoli SunDepartment of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Suthat LiangpunsakulDivision of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Bin GaoLaboratory of Liver Diseases, National Institute on Alcohol Abuse and Alcoholism (NIAAA), NIH, Bethesda, Maryland, USA.
National Institute on Alcohol Abuse and Alcoholism · USJohns Hopkins University · USIndiana University School of MedicineUniversity of Pittsburgh Medical Center · USCentro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas · ESCharité - Universitätsmedizin Berlin · DEEmory University · USRichard L. Roudebush VA Medical Center · USThe University of Texas Health Science Center at San Antonio · US

Funding

The Southernearch Center for ALPD and CirrhosisP50AA011999 · NIAAA · UNIVERSITY OF SOUTHERN CALIFORNIA · PI HIDEKAZU TSUKAMOTO · 1999 to 2026
$45.8M
Pathogenesis and Novel Therapeutic Targets of Steatotic Liver Disease and CancerZIAAA000369 · NIAAA · NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM · PI GAO, BIN · 2009 to 2025
$23.4M
Project 4-Early Liver Transplantation for Severe Alcoholic Hepatitis: Animal StudiesP50AA027054 · NIAAA · JOHNS HOPKINS UNIVERSITY · PI ANDREW M. CAMERON · 2019 to 2026
$15.1M
Clinical Resources for Alcoholic Hepatitis InvestigationsR24AA025017 · NIAAA · JOHNS HOPKINS UNIVERSITY · PI ZHAOLI SUN · 2016 to 2026
$6.6M
Molecular Subtypes for Targeted Therapies in Alcoholic HepatitisU01AA021908 · NIAAA · UNIV OF NORTH CAROLINA CHAPEL HILL · PI BATALLER, RAMON · 2013 to 2017
$6.0M
MIF in progression and treatment of ALDU01AA020821 · NIAAA · CLEVELAND CLINIC LERNER COM-CWRU · PI NAGY, LAURA E. · 2012 to 2016
$2.1M
S-adenosylmethionine treatment in alcoholic cirrhosisU01AA026817 · NIAAA · INDIANA UNIVERSITY INDIANAPOLIS · PI GAO, BIN, LIANGPUNSAKUL, SUTHAT · 2019 to 2024
$2.1M
Novel biomarkers as a clinical tool for excessive alcohol use screeningR01AA025208 · NIAAA · INDIANA UNIVERSITY INDIANAPOLIS · PI LIANGPUNSAKUL, SUTHAT, TU, WANZHU · 2016 to 2020
$1.7M
Liver-enriched Transcription Factors as Prognostic Markers and Therapeutic Targets in Alcoholic HepatitisU01AA026972 · NIAAA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI ARTEEL, GAVIN E · 2018 to 2022
$1.2M
Immunological Profiles and prognostic outcomes in patients with alcoholic hepatitisU01AA026917 · NIAAA · INDIANA UNIVERSITY INDIANAPOLIS · PI LIANGPUNSAKUL, SUTHAT · 2018 to 2022
$1.2M
Integrating LncRNA to Methionine Metabolism in Alcoholic Fatty LiverK01AA026385 · NIAAA · INDIANA UNIVERSITY INDIANAPOLIS · PI YANG, ZHIHONG · 2018 to 2022
$807k
Hepatokine Control of Metabolic Crosstalk and Insulin ResistanceR01DK121527 · NIDDK · UNIVERSITY OF TEXAS HLTH SCIENCE CENTER · PI ZANG, MENGWEI · 2019 to 2020
$612k
NIAAA NIH HHS K01 AA026385NIAAA NIH HHS P50 AA011999NIAAA NIH HHS P50 AA027054NIAAA NIH HHS R01 AA025208NIAAA NIH HHS R21 AA026922NIAAA NIH HHS R24 AA025017NIAAA NIH HHS U01 AA020821NIAAA NIH HHS U01 AA021908NIAAA NIH HHS U01 AA026817NIAAA NIH HHS U01 AA026917NIAAA NIH HHS U01 AA026972NIAAA NIH HHS UH2 AA026903NIDDK NIH HHS R01 DK121527
6 · The paper itself

Abstract

Intrahepatic neutrophil infiltration has been implicated in severe alcoholic hepatitis (SAH) pathogenesis; however, the mechanism underlying neutrophil-induced injury in SAH remains obscure. This translational study aims to describe the patterns of intrahepatic neutrophil infiltration and its involvement in SAH pathogenesis. Immunohistochemistry analyses of explanted livers identified two SAH phenotypes despite a similar clinical presentation, one with high intrahepatic neutrophils (Neuhi), but low levels of CD8+ T cells, and vice versa. RNA-Seq analyses demonstrated that neutrophil cytosolic factor 1 (NCF1), a key factor in controlling neutrophilic ROS production, was upregulated and correlated with hepatic inflammation and disease progression. To study specifically the mechanisms related to Neuhi in AH patients and liver injury, we used the mouse model of chronic-plus-binge ethanol feeding and found that myeloid-specific deletion of the Ncf1 gene abolished ethanol-induced hepatic inflammation and steatosis. RNA-Seq analysis and the data from experimental models revealed that neutrophilic NCF1-dependent ROS promoted alcoholic hepatitis (AH) by inhibiting AMP-activated protein kinase (a key regulator of lipid metabolism) and microRNA-223 (a key antiinflammatory and antifibrotic microRNA). In conclusion, two distinct histopathological phenotypes based on liver immune phenotyping are observed in SAH patients, suggesting a separate mechanism driving liver injury and/or failure in these patients.

Indexed as

Hepatitis, AlcoholicLiver Diseases, AlcoholicAnimalsEthanolInflammationLiverMiceMice, Inbred C57BLPhenotypeReactive Oxygen SpeciesEthanolReactive Oxygen SpeciesGastroenterologyHepatitis

Identifiers

PMID35838051
PMCPMC9282929
OpenAlexW4285385617

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.