Q1 · BIOLOGY
Article
Author: Watanabe-Chailland, Miki ; Dunn, Andrew ; Takebe, Takanori ; Iwasawa, Kentaro ; Kumbaji, Meenasri ; Chaturvedi, Praneet ; Chung, Chuhan ; Myers, Robert P ; Zorn, Aaron M ; Gindin, Yevgeniy ; Yoneyama, Yosuke ; Kodaka, Asuka ; Kimura, Masaki ; Subramanian, G Mani ; Zhu, Gaohui ; Hwa, Vivian ; Wintzinger, Michelle ; Quattrocelli, Mattia ; Iguchi, Takuma ; Fujimoto, Masanobu ; Thompson, Wendy L
Genotype-phenotype associations for common diseases are often compounded by pleiotropy and metabolic state. Here, we devised a pooled human organoid-panel of steatohepatitis to investigate the impact of metabolic status on genotype-phenotype association. En masse population-based phenotypic analysis under insulin insensitive conditions predicted key non-alcoholic steatohepatitis (NASH)-genetic factors including the glucokinase regulatory protein (GCKR)-rs1260326:C>T. Analysis of NASH clinical cohorts revealed that GCKR-rs1260326-T allele elevates disease severity only under diabetic state but protects from fibrosis under non-diabetic states. Transcriptomic, metabolomic, and pharmacological analyses indicate significant mitochondrial dysfunction incurred by GCKR-rs1260326, which was not reversed with metformin. Uncoupling oxidative mechanisms mitigated mitochondrial dysfunction and permitted adaptation to increased fatty acid supply while protecting against oxidant stress, forming a basis for future therapeutic approaches for diabetic NASH. Thus, "in-a-dish" genotype-phenotype association strategies disentangle the opposing roles of metabolic-associated gene variant functions and offer a rich mechanistic, diagnostic, and therapeutic inference toolbox toward precision hepatology. VIDEO ABSTRACT.