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ResearchIn-Press PreviewGastroenterologyHepatology Open Access | 10.1172/jci.insight.193805

PNPLA3-I148M genetic variant rewires lipid metabolism to drive programmed cell death in human hepatocytes

Rodrigo M. Florentino,1 Olamide Animasahun,2 Nils Haep,1 Minal Nenwani,3 Kehinde Omoloja,4 Leyla Nurcihan Altay,4 Abhinav Achreja,3 Kazutoyo Morita,1 Takashi Motomura,1 Ricardo Diaz-Aragon,1 Lanuza AP Faccioli,1 Yiyue Sun,1 Zhenghao Liu,1 Zhiping Hu,1 Bo Yang,1 Fulei Wuchu,3 Ajay Shankaran,4 Miya Paserba,3 Annalisa M. Baratta,1 Shohrat Arazov,1 Zehra N. Kocas-Kilicarslan,1 Noah Meurs,3 Jaideep Behari,5 Edgar N. Tafaleng,1 Jonathan Franks,6 Alina Ostrowska,1 Takahiro Tomiyama,7 Kyohei Yugawa,7 Akinari Morinaga,7 Zi Wang,8 Kazuki Takeishi,7 Dillon C. Gavlock,9 Mark Miedel,9 D. Lansing Taylor,10 Ira J. Fox,11 Tomoharu Yoshizumi,7 Deepak Nagrath,2 and Alejandro Soto-Gutierrez1

1Department of Pathology, University of Pittsburgh, Pittsburgh, United States of America

2Center for Transcriptional Medicine, University of Pittsburgh, Pittsburgh, United States of America

3Biointerfaces Institute, University of Michigan, Ann Arbor, United States of America

4Department of Chemical Engineering, University of Michigan, Ann Arbor, United States of America

5Department of Medicine, Division of Gastroenterology, Hepatology, and Nutri, University of Pittsburgh Medical Center, Pittsburgh, United States of America

6Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, United States of America

7Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

8Department of Statistic, University of Pittsburgh, Pittsburgh, United States of America

9University of Pittsburgh Drug Discovery Institute, University of Pittsburgh, Pittsburgh, United States of America

10Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, United States of America

11Department of Surgery, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, United States of America

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1Department of Pathology, University of Pittsburgh, Pittsburgh, United States of America

2Center for Transcriptional Medicine, University of Pittsburgh, Pittsburgh, United States of America

3Biointerfaces Institute, University of Michigan, Ann Arbor, United States of America

4Department of Chemical Engineering, University of Michigan, Ann Arbor, United States of America

5Department of Medicine, Division of Gastroenterology, Hepatology, and Nutri, University of Pittsburgh Medical Center, Pittsburgh, United States of America

6Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, United States of America

7Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

8Department of Statistic, University of Pittsburgh, Pittsburgh, United States of America

9University of Pittsburgh Drug Discovery Institute, University of Pittsburgh, Pittsburgh, United States of America

10Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, United States of America

11Department of Surgery, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, United States of America

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1Department of Pathology, University of Pittsburgh, Pittsburgh, United States of America

2Center for Transcriptional Medicine, University of Pittsburgh, Pittsburgh, United States of America

3Biointerfaces Institute, University of Michigan, Ann Arbor, United States of America

4Department of Chemical Engineering, University of Michigan, Ann Arbor, United States of America

5Department of Medicine, Division of Gastroenterology, Hepatology, and Nutri, University of Pittsburgh Medical Center, Pittsburgh, United States of America

6Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, United States of America

7Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

8Department of Statistic, University of Pittsburgh, Pittsburgh, United States of America

9University of Pittsburgh Drug Discovery Institute, University of Pittsburgh, Pittsburgh, United States of America

10Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, United States of America

11Department of Surgery, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, United States of America

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1Department of Pathology, University of Pittsburgh, Pittsburgh, United States of America

2Center for Transcriptional Medicine, University of Pittsburgh, Pittsburgh, United States of America

3Biointerfaces Institute, University of Michigan, Ann Arbor, United States of America

4Department of Chemical Engineering, University of Michigan, Ann Arbor, United States of America

5Department of Medicine, Division of Gastroenterology, Hepatology, and Nutri, University of Pittsburgh Medical Center, Pittsburgh, United States of America

6Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, United States of America

7Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

8Department of Statistic, University of Pittsburgh, Pittsburgh, United States of America

9University of Pittsburgh Drug Discovery Institute, University of Pittsburgh, Pittsburgh, United States of America

10Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, United States of America

11Department of Surgery, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, United States of America

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1Department of Pathology, University of Pittsburgh, Pittsburgh, United States of America

2Center for Transcriptional Medicine, University of Pittsburgh, Pittsburgh, United States of America

3Biointerfaces Institute, University of Michigan, Ann Arbor, United States of America

4Department of Chemical Engineering, University of Michigan, Ann Arbor, United States of America

5Department of Medicine, Division of Gastroenterology, Hepatology, and Nutri, University of Pittsburgh Medical Center, Pittsburgh, United States of America

6Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, United States of America

7Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

8Department of Statistic, University of Pittsburgh, Pittsburgh, United States of America

9University of Pittsburgh Drug Discovery Institute, University of Pittsburgh, Pittsburgh, United States of America

10Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, United States of America

11Department of Surgery, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, United States of America

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1Department of Pathology, University of Pittsburgh, Pittsburgh, United States of America

2Center for Transcriptional Medicine, University of Pittsburgh, Pittsburgh, United States of America

3Biointerfaces Institute, University of Michigan, Ann Arbor, United States of America

4Department of Chemical Engineering, University of Michigan, Ann Arbor, United States of America

5Department of Medicine, Division of Gastroenterology, Hepatology, and Nutri, University of Pittsburgh Medical Center, Pittsburgh, United States of America

6Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, United States of America

7Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

8Department of Statistic, University of Pittsburgh, Pittsburgh, United States of America

9University of Pittsburgh Drug Discovery Institute, University of Pittsburgh, Pittsburgh, United States of America

10Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, United States of America

11Department of Surgery, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, United States of America

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1Department of Pathology, University of Pittsburgh, Pittsburgh, United States of America

2Center for Transcriptional Medicine, University of Pittsburgh, Pittsburgh, United States of America

3Biointerfaces Institute, University of Michigan, Ann Arbor, United States of America

4Department of Chemical Engineering, University of Michigan, Ann Arbor, United States of America

5Department of Medicine, Division of Gastroenterology, Hepatology, and Nutri, University of Pittsburgh Medical Center, Pittsburgh, United States of America

6Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, United States of America

7Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

8Department of Statistic, University of Pittsburgh, Pittsburgh, United States of America

9University of Pittsburgh Drug Discovery Institute, University of Pittsburgh, Pittsburgh, United States of America

10Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, United States of America

11Department of Surgery, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, United States of America

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1Department of Pathology, University of Pittsburgh, Pittsburgh, United States of America

2Center for Transcriptional Medicine, University of Pittsburgh, Pittsburgh, United States of America

3Biointerfaces Institute, University of Michigan, Ann Arbor, United States of America

4Department of Chemical Engineering, University of Michigan, Ann Arbor, United States of America

5Department of Medicine, Division of Gastroenterology, Hepatology, and Nutri, University of Pittsburgh Medical Center, Pittsburgh, United States of America

6Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, United States of America

7Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

8Department of Statistic, University of Pittsburgh, Pittsburgh, United States of America

9University of Pittsburgh Drug Discovery Institute, University of Pittsburgh, Pittsburgh, United States of America

10Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, United States of America

11Department of Surgery, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, United States of America

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1Department of Pathology, University of Pittsburgh, Pittsburgh, United States of America

2Center for Transcriptional Medicine, University of Pittsburgh, Pittsburgh, United States of America

3Biointerfaces Institute, University of Michigan, Ann Arbor, United States of America

4Department of Chemical Engineering, University of Michigan, Ann Arbor, United States of America

5Department of Medicine, Division of Gastroenterology, Hepatology, and Nutri, University of Pittsburgh Medical Center, Pittsburgh, United States of America

6Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, United States of America

7Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

8Department of Statistic, University of Pittsburgh, Pittsburgh, United States of America

9University of Pittsburgh Drug Discovery Institute, University of Pittsburgh, Pittsburgh, United States of America

10Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, United States of America

11Department of Surgery, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, United States of America

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1Department of Pathology, University of Pittsburgh, Pittsburgh, United States of America

2Center for Transcriptional Medicine, University of Pittsburgh, Pittsburgh, United States of America

3Biointerfaces Institute, University of Michigan, Ann Arbor, United States of America

4Department of Chemical Engineering, University of Michigan, Ann Arbor, United States of America

5Department of Medicine, Division of Gastroenterology, Hepatology, and Nutri, University of Pittsburgh Medical Center, Pittsburgh, United States of America

6Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, United States of America

7Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

8Department of Statistic, University of Pittsburgh, Pittsburgh, United States of America

9University of Pittsburgh Drug Discovery Institute, University of Pittsburgh, Pittsburgh, United States of America

10Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, United States of America

11Department of Surgery, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, United States of America

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1Department of Pathology, University of Pittsburgh, Pittsburgh, United States of America

2Center for Transcriptional Medicine, University of Pittsburgh, Pittsburgh, United States of America

3Biointerfaces Institute, University of Michigan, Ann Arbor, United States of America

4Department of Chemical Engineering, University of Michigan, Ann Arbor, United States of America

5Department of Medicine, Division of Gastroenterology, Hepatology, and Nutri, University of Pittsburgh Medical Center, Pittsburgh, United States of America

6Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, United States of America

7Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

8Department of Statistic, University of Pittsburgh, Pittsburgh, United States of America

9University of Pittsburgh Drug Discovery Institute, University of Pittsburgh, Pittsburgh, United States of America

10Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, United States of America

11Department of Surgery, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, United States of America

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1Department of Pathology, University of Pittsburgh, Pittsburgh, United States of America

2Center for Transcriptional Medicine, University of Pittsburgh, Pittsburgh, United States of America

3Biointerfaces Institute, University of Michigan, Ann Arbor, United States of America

4Department of Chemical Engineering, University of Michigan, Ann Arbor, United States of America

5Department of Medicine, Division of Gastroenterology, Hepatology, and Nutri, University of Pittsburgh Medical Center, Pittsburgh, United States of America

6Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, United States of America

7Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

8Department of Statistic, University of Pittsburgh, Pittsburgh, United States of America

9University of Pittsburgh Drug Discovery Institute, University of Pittsburgh, Pittsburgh, United States of America

10Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, United States of America

11Department of Surgery, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, United States of America

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1Department of Pathology, University of Pittsburgh, Pittsburgh, United States of America

2Center for Transcriptional Medicine, University of Pittsburgh, Pittsburgh, United States of America

3Biointerfaces Institute, University of Michigan, Ann Arbor, United States of America

4Department of Chemical Engineering, University of Michigan, Ann Arbor, United States of America

5Department of Medicine, Division of Gastroenterology, Hepatology, and Nutri, University of Pittsburgh Medical Center, Pittsburgh, United States of America

6Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, United States of America

7Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

8Department of Statistic, University of Pittsburgh, Pittsburgh, United States of America

9University of Pittsburgh Drug Discovery Institute, University of Pittsburgh, Pittsburgh, United States of America

10Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, United States of America

11Department of Surgery, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, United States of America

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1Department of Pathology, University of Pittsburgh, Pittsburgh, United States of America

2Center for Transcriptional Medicine, University of Pittsburgh, Pittsburgh, United States of America

3Biointerfaces Institute, University of Michigan, Ann Arbor, United States of America

4Department of Chemical Engineering, University of Michigan, Ann Arbor, United States of America

5Department of Medicine, Division of Gastroenterology, Hepatology, and Nutri, University of Pittsburgh Medical Center, Pittsburgh, United States of America

6Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, United States of America

7Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

8Department of Statistic, University of Pittsburgh, Pittsburgh, United States of America

9University of Pittsburgh Drug Discovery Institute, University of Pittsburgh, Pittsburgh, United States of America

10Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, United States of America

11Department of Surgery, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, United States of America

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1Department of Pathology, University of Pittsburgh, Pittsburgh, United States of America

2Center for Transcriptional Medicine, University of Pittsburgh, Pittsburgh, United States of America

3Biointerfaces Institute, University of Michigan, Ann Arbor, United States of America

4Department of Chemical Engineering, University of Michigan, Ann Arbor, United States of America

5Department of Medicine, Division of Gastroenterology, Hepatology, and Nutri, University of Pittsburgh Medical Center, Pittsburgh, United States of America

6Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, United States of America

7Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

8Department of Statistic, University of Pittsburgh, Pittsburgh, United States of America

9University of Pittsburgh Drug Discovery Institute, University of Pittsburgh, Pittsburgh, United States of America

10Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, United States of America

11Department of Surgery, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, United States of America

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1Department of Pathology, University of Pittsburgh, Pittsburgh, United States of America

2Center for Transcriptional Medicine, University of Pittsburgh, Pittsburgh, United States of America

3Biointerfaces Institute, University of Michigan, Ann Arbor, United States of America

4Department of Chemical Engineering, University of Michigan, Ann Arbor, United States of America

5Department of Medicine, Division of Gastroenterology, Hepatology, and Nutri, University of Pittsburgh Medical Center, Pittsburgh, United States of America

6Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, United States of America

7Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

8Department of Statistic, University of Pittsburgh, Pittsburgh, United States of America

9University of Pittsburgh Drug Discovery Institute, University of Pittsburgh, Pittsburgh, United States of America

10Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, United States of America

11Department of Surgery, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, United States of America

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1Department of Pathology, University of Pittsburgh, Pittsburgh, United States of America

2Center for Transcriptional Medicine, University of Pittsburgh, Pittsburgh, United States of America

3Biointerfaces Institute, University of Michigan, Ann Arbor, United States of America

4Department of Chemical Engineering, University of Michigan, Ann Arbor, United States of America

5Department of Medicine, Division of Gastroenterology, Hepatology, and Nutri, University of Pittsburgh Medical Center, Pittsburgh, United States of America

6Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, United States of America

7Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

8Department of Statistic, University of Pittsburgh, Pittsburgh, United States of America

9University of Pittsburgh Drug Discovery Institute, University of Pittsburgh, Pittsburgh, United States of America

10Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, United States of America

11Department of Surgery, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, United States of America

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1Department of Pathology, University of Pittsburgh, Pittsburgh, United States of America

2Center for Transcriptional Medicine, University of Pittsburgh, Pittsburgh, United States of America

3Biointerfaces Institute, University of Michigan, Ann Arbor, United States of America

4Department of Chemical Engineering, University of Michigan, Ann Arbor, United States of America

5Department of Medicine, Division of Gastroenterology, Hepatology, and Nutri, University of Pittsburgh Medical Center, Pittsburgh, United States of America

6Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, United States of America

7Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

8Department of Statistic, University of Pittsburgh, Pittsburgh, United States of America

9University of Pittsburgh Drug Discovery Institute, University of Pittsburgh, Pittsburgh, United States of America

10Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, United States of America

11Department of Surgery, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, United States of America

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1Department of Pathology, University of Pittsburgh, Pittsburgh, United States of America

2Center for Transcriptional Medicine, University of Pittsburgh, Pittsburgh, United States of America

3Biointerfaces Institute, University of Michigan, Ann Arbor, United States of America

4Department of Chemical Engineering, University of Michigan, Ann Arbor, United States of America

5Department of Medicine, Division of Gastroenterology, Hepatology, and Nutri, University of Pittsburgh Medical Center, Pittsburgh, United States of America

6Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, United States of America

7Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

8Department of Statistic, University of Pittsburgh, Pittsburgh, United States of America

9University of Pittsburgh Drug Discovery Institute, University of Pittsburgh, Pittsburgh, United States of America

10Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, United States of America

11Department of Surgery, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, United States of America

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1Department of Pathology, University of Pittsburgh, Pittsburgh, United States of America

2Center for Transcriptional Medicine, University of Pittsburgh, Pittsburgh, United States of America

3Biointerfaces Institute, University of Michigan, Ann Arbor, United States of America

4Department of Chemical Engineering, University of Michigan, Ann Arbor, United States of America

5Department of Medicine, Division of Gastroenterology, Hepatology, and Nutri, University of Pittsburgh Medical Center, Pittsburgh, United States of America

6Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, United States of America

7Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

8Department of Statistic, University of Pittsburgh, Pittsburgh, United States of America

9University of Pittsburgh Drug Discovery Institute, University of Pittsburgh, Pittsburgh, United States of America

10Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, United States of America

11Department of Surgery, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, United States of America

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1Department of Pathology, University of Pittsburgh, Pittsburgh, United States of America

2Center for Transcriptional Medicine, University of Pittsburgh, Pittsburgh, United States of America

3Biointerfaces Institute, University of Michigan, Ann Arbor, United States of America

4Department of Chemical Engineering, University of Michigan, Ann Arbor, United States of America

5Department of Medicine, Division of Gastroenterology, Hepatology, and Nutri, University of Pittsburgh Medical Center, Pittsburgh, United States of America

6Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, United States of America

7Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

8Department of Statistic, University of Pittsburgh, Pittsburgh, United States of America

9University of Pittsburgh Drug Discovery Institute, University of Pittsburgh, Pittsburgh, United States of America

10Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, United States of America

11Department of Surgery, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, United States of America

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1Department of Pathology, University of Pittsburgh, Pittsburgh, United States of America

2Center for Transcriptional Medicine, University of Pittsburgh, Pittsburgh, United States of America

3Biointerfaces Institute, University of Michigan, Ann Arbor, United States of America

4Department of Chemical Engineering, University of Michigan, Ann Arbor, United States of America

5Department of Medicine, Division of Gastroenterology, Hepatology, and Nutri, University of Pittsburgh Medical Center, Pittsburgh, United States of America

6Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, United States of America

7Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

8Department of Statistic, University of Pittsburgh, Pittsburgh, United States of America

9University of Pittsburgh Drug Discovery Institute, University of Pittsburgh, Pittsburgh, United States of America

10Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, United States of America

11Department of Surgery, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, United States of America

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1Department of Pathology, University of Pittsburgh, Pittsburgh, United States of America

2Center for Transcriptional Medicine, University of Pittsburgh, Pittsburgh, United States of America

3Biointerfaces Institute, University of Michigan, Ann Arbor, United States of America

4Department of Chemical Engineering, University of Michigan, Ann Arbor, United States of America

5Department of Medicine, Division of Gastroenterology, Hepatology, and Nutri, University of Pittsburgh Medical Center, Pittsburgh, United States of America

6Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, United States of America

7Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

8Department of Statistic, University of Pittsburgh, Pittsburgh, United States of America

9University of Pittsburgh Drug Discovery Institute, University of Pittsburgh, Pittsburgh, United States of America

10Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, United States of America

11Department of Surgery, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, United States of America

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1Department of Pathology, University of Pittsburgh, Pittsburgh, United States of America

2Center for Transcriptional Medicine, University of Pittsburgh, Pittsburgh, United States of America

3Biointerfaces Institute, University of Michigan, Ann Arbor, United States of America

4Department of Chemical Engineering, University of Michigan, Ann Arbor, United States of America

5Department of Medicine, Division of Gastroenterology, Hepatology, and Nutri, University of Pittsburgh Medical Center, Pittsburgh, United States of America

6Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, United States of America

7Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

8Department of Statistic, University of Pittsburgh, Pittsburgh, United States of America

9University of Pittsburgh Drug Discovery Institute, University of Pittsburgh, Pittsburgh, United States of America

10Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, United States of America

11Department of Surgery, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, United States of America

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1Department of Pathology, University of Pittsburgh, Pittsburgh, United States of America

2Center for Transcriptional Medicine, University of Pittsburgh, Pittsburgh, United States of America

3Biointerfaces Institute, University of Michigan, Ann Arbor, United States of America

4Department of Chemical Engineering, University of Michigan, Ann Arbor, United States of America

5Department of Medicine, Division of Gastroenterology, Hepatology, and Nutri, University of Pittsburgh Medical Center, Pittsburgh, United States of America

6Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, United States of America

7Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

8Department of Statistic, University of Pittsburgh, Pittsburgh, United States of America

9University of Pittsburgh Drug Discovery Institute, University of Pittsburgh, Pittsburgh, United States of America

10Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, United States of America

11Department of Surgery, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, United States of America

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1Department of Pathology, University of Pittsburgh, Pittsburgh, United States of America

2Center for Transcriptional Medicine, University of Pittsburgh, Pittsburgh, United States of America

3Biointerfaces Institute, University of Michigan, Ann Arbor, United States of America

4Department of Chemical Engineering, University of Michigan, Ann Arbor, United States of America

5Department of Medicine, Division of Gastroenterology, Hepatology, and Nutri, University of Pittsburgh Medical Center, Pittsburgh, United States of America

6Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, United States of America

7Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

8Department of Statistic, University of Pittsburgh, Pittsburgh, United States of America

9University of Pittsburgh Drug Discovery Institute, University of Pittsburgh, Pittsburgh, United States of America

10Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, United States of America

11Department of Surgery, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, United States of America

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1Department of Pathology, University of Pittsburgh, Pittsburgh, United States of America

2Center for Transcriptional Medicine, University of Pittsburgh, Pittsburgh, United States of America

3Biointerfaces Institute, University of Michigan, Ann Arbor, United States of America

4Department of Chemical Engineering, University of Michigan, Ann Arbor, United States of America

5Department of Medicine, Division of Gastroenterology, Hepatology, and Nutri, University of Pittsburgh Medical Center, Pittsburgh, United States of America

6Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, United States of America

7Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

8Department of Statistic, University of Pittsburgh, Pittsburgh, United States of America

9University of Pittsburgh Drug Discovery Institute, University of Pittsburgh, Pittsburgh, United States of America

10Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, United States of America

11Department of Surgery, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, United States of America

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1Department of Pathology, University of Pittsburgh, Pittsburgh, United States of America

2Center for Transcriptional Medicine, University of Pittsburgh, Pittsburgh, United States of America

3Biointerfaces Institute, University of Michigan, Ann Arbor, United States of America

4Department of Chemical Engineering, University of Michigan, Ann Arbor, United States of America

5Department of Medicine, Division of Gastroenterology, Hepatology, and Nutri, University of Pittsburgh Medical Center, Pittsburgh, United States of America

6Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, United States of America

7Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

8Department of Statistic, University of Pittsburgh, Pittsburgh, United States of America

9University of Pittsburgh Drug Discovery Institute, University of Pittsburgh, Pittsburgh, United States of America

10Pittsburgh Liver Research Center, University of Pittsburgh, Pittsburgh, United States of America

11Department of Surgery, Children’s Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, United States of America

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1Department of Pathology, University of Pittsburgh, Pittsburgh, United States of America

2Center for Transcriptional Medicine, University of Pittsburgh, Pittsburgh, United States of America

3Biointerfaces Institute, University of Michigan, Ann Arbor, United States of America

4Department of Chemical Engineering, University of Michigan, Ann Arbor, United States of America

5Department of Medicine, Division of Gastroenterology, Hepatology, and Nutri, University of Pittsburgh Medical Center, Pittsburgh, United States of America

6Center for Biologic Imaging, University of Pittsburgh, Pittsburgh, United States of America

7Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

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Published October 21, 2025 - More info

JCI Insight. https://doi.org/10.1172/jci.insight.193805.
Copyright © 2025, Florentino et al. This work is licensed under the Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
Published October 21, 2025 - Version history
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Abstract

Genetic variants in lipid metabolism influence the risk of developing metabolic dysfunction-associated steatotic liver disease (MASLD), cirrhosis, and end-stage liver disease (ESLD). The mechanisms by which these variants drive disease are poorly understood. Because of the PNPLA3-I148M variant's strong correlation with all stages of the MASLD spectrum and the lack of tractable therapeutic targets, we sought to understand its impact on cellular function and liver metabolism. Primary human hepatocytes (HAH) and iPSC-derived hepatocytes (iHeps) from healthy individuals possessing the PNPLA3-I148M mutation were characterized for changes in lipid metabolism, cellular stress, and survival. Using lipidomics, metabolomics, stable isotope tracing, and flux propensity analysis, we created a comprehensive metabolic profile of the changes associated with the PNPLA3-I148M variant. Functional analysis showed that the presence of the PNPLA3-I148M variant increased endoplasmic reticulum stress, mitochondrial dysfunction, and peroxisomal β-oxidation, ultimately leading to cell death via ferroptosis. Nutritional interventions, ferroptosis-specific inhibitors, and genetic approaches modulating GPX4 activity in PNPLA3-I148M HAH and iHeps decreased programmed cell death. Our findings indicate that therapies targeting ferroptosis in patients carrying the PNPLA3-I148M variant could affect the development of MASLD and ESLD and highlight the utility of iPSC-based models for the study of genetic contributions to hepatic disorders.

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