PDL-1+ Neutrophils mediate susceptibility during endotoxemia in Metabolically Dysfunctional-Associated Fatty Liver Disease

Metabolically Dysfunctional-Associated Fatty Liver Disease (MAFLD) is a pathological condition affecting many individuals worldwide. Patients with MAFLD are more susceptible to systemic inflammation, including endotoxemia, which accelerates the progressive liver damage. However, the immunological mechanisms that trigger the hyper-inflammatory responses in individuals with MAFLD remain unknown. In the present study, we reported that short-term HFCD (Choline Deficient High Fat Diet)-fed mice, which did not show significant signs of hepatic damage and inflammation in the first two weeks, are more susceptible to a non-severe sepsis-like systemic inflammation induced by LPS challenge. Mechanistically, endotoxemic mice show an excessive accumulation of NK-producing IFN-γ cells in liver tissue, which trigger the recruitment and polarization of a distinct subset of neutrophils, characterized by high expression of PD-L1 and massive release of TNFα. Remarkably, genetic inhibition of IFN-γ or pharmacological blockade of PD-L1 effectively modulated the excessive recruitment of these neutrophils to the liver and TNF-α production, thereby preventing hepatic damage and reducing the severity of host mortality. Thus, these results support the design of novel effective strategies to control hyperinflammatory responses in septic HFCD patients and consequently improve their survival.