ArticleJournal of the American Heart Association2025
Comprehensive Multiomic Analysis Reveals Metabolic Reprogramming Underlying Human Fontan-Associated Liver Disease.
Article in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Pharmacokinetics in the Fontan circulation: a multi-organ puzzle.European heart journal. Cardiovascular pharmacotherapy · 2026Review
- Proteomic Remodeling in Fontan Circulation Associated with Fibrosis and Time-Dependent Immune-Metabolic Alteration.International journal of molecular sciences · 2026Article
- Functionally Single-Ventricle Complications After Fontan Palliation-A Narrative Review.Journal of clinical medicine · 2026Review
- Reply: Fibrosis Is Inevitable, but Heterogeneous: Time-Dependent and Biochemical Modifiers of Liver Injury After Fontan Completion.JACC. Advances · 2026Article
- Prognostic biomarkers in Fontan associated liver disease.Translational pediatrics · 2026Review
- Fibrosis 4 Index Predicts Haemocompatibility-Related Adverse Events in Patients Using Left Ventricular Assist Devices.European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery · 2025Article
- Obstetric complications in pregnant people with Fontan circulation: Identifying candidate pathologic pathways in the placenta.Pregnancy (Hoboken, N.J.) · 2025Article
- Overcoming borders: International cooperation in re-use and re-interpretation of omics data in Fontan circulation.International journal of cardiology. Congenital heart disease · 2025Article
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Authors and funding
7 authors.
Funding
Abstract
backgroundThe Fontan operation is the current standard of care for single-ventricle congenital heart disease. Almost all patients with Fontan operation develop liver fibrosis at a young age, known as Fontan-associated liver disease (FALD). The pathogenesis and mechanisms underlying FALD remain little understood, and there are no effective therapies. We aimed to present a comprehensive multiomic analysis of human FALD, revealing the fundamental biology and pathogenesis of FALD. METHODS AND
resultsWe recently generated a single-cell transcriptomic and epigenomic atlas of human FALD using single-nucleus multiomic RNA sequencing and assay for transposase-accessible chromatin using sequencing, which uncovered substantial metabolic reprogramming. Here, we applied liquid chromatography-mass spectrometry-based untargeted metabolomics to unveil the metabolomic landscape of human FALD, using liver samples/biopsies from age- and sex-matched donors and patients with FALD (n=12 per group). Results were integrated with liver single-nucleus multiomic RNA sequencing and assay for transposase-accessible chromatin using sequencing and serum metabolomics data to present a comprehensive multiomic atlas of FALD.We discovered significant metabolic abnormalities in livers of adolescent patients with Fontan circulation, particularly amino acid metabolism, peroxisomal fatty acid oxidation, cytochrome P450 system, glycolysis, tricarboxylic acid cycle, ketone body metabolism, and bile acid metabolism. Integrated analyses with liver single-nucleus multiomic RNA sequencing and assay for transposase-accessible chromatin using sequencing results unveiled potential underlying mechanisms of these metabolic changes. Comparison with serum metabolomics data indicate that liver metabolic reprogramming contributes to circulatory metabolomic changes in FALD. Furthermore, comparison with metabolomics data of human metabolic dysfunction-associated fatty liver disease and metabolic dysfunction-associated steatohepatitis highlighted dysregulated amino acid metabolism as a common metabolic abnormality.
conclusionsOur comprehensive multiomic analyses reveal new insights into the fundamental biology and pathogenesis mechanisms of human FALD.
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