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ResearchIn-Press PreviewHepatologyVascular biology Open Access | 10.1172/jci.insight.202552

Endothelial Cell Glycogen Synthase Kinase 3β Promotes Lipotoxic Endotheliopathy and Liver Inflammation in MASH

Akitoshi Sano,1 Qianqian Guo,1 Khaled Warasnhe,1 Chady Meroueh,2 Nantawat Satthawiwat,1 Asma Hamdi,3 Ghefar Hmaydoosh,1 Xin Dai,1 Usman Yaqoob,1 Kevin D. Pavelko,4 Charlene Miciano,5 Tatiana Kisseleva,6 Zeba Firdaus,7 Patrick P. Starlinger,8 David Pereyra,8 Enis Kostallari,1 Petra Hirsova,1 Davide Povero,1 and Samar H. Ibrahim1

1Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

2Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, United States of America

3Division of Pediatric Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

4Immune Monitoring Core, Mayo Clinic, Rochester, United States of America

5Department of Cellular and Molecular Medicine, University of California San Diego School of Medicine, La Jolla, United States of America

6Department of Surgery, University of California San Diego School of Medicine, La Jolla, United States of America

7Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, United States of America

8Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, Mayo Clinic, Rochester, United States of America

Find articles by Sano, A. in: PubMed | Google Scholar

1Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

2Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, United States of America

3Division of Pediatric Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

4Immune Monitoring Core, Mayo Clinic, Rochester, United States of America

5Department of Cellular and Molecular Medicine, University of California San Diego School of Medicine, La Jolla, United States of America

6Department of Surgery, University of California San Diego School of Medicine, La Jolla, United States of America

7Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, United States of America

8Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, Mayo Clinic, Rochester, United States of America

Find articles by Guo, Q. in: PubMed | Google Scholar |

1Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

2Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, United States of America

3Division of Pediatric Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

4Immune Monitoring Core, Mayo Clinic, Rochester, United States of America

5Department of Cellular and Molecular Medicine, University of California San Diego School of Medicine, La Jolla, United States of America

6Department of Surgery, University of California San Diego School of Medicine, La Jolla, United States of America

7Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, United States of America

8Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, Mayo Clinic, Rochester, United States of America

Find articles by Warasnhe, K. in: PubMed | Google Scholar

1Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

2Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, United States of America

3Division of Pediatric Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

4Immune Monitoring Core, Mayo Clinic, Rochester, United States of America

5Department of Cellular and Molecular Medicine, University of California San Diego School of Medicine, La Jolla, United States of America

6Department of Surgery, University of California San Diego School of Medicine, La Jolla, United States of America

7Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, United States of America

8Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, Mayo Clinic, Rochester, United States of America

Find articles by Meroueh, C. in: PubMed | Google Scholar

1Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

2Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, United States of America

3Division of Pediatric Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

4Immune Monitoring Core, Mayo Clinic, Rochester, United States of America

5Department of Cellular and Molecular Medicine, University of California San Diego School of Medicine, La Jolla, United States of America

6Department of Surgery, University of California San Diego School of Medicine, La Jolla, United States of America

7Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, United States of America

8Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, Mayo Clinic, Rochester, United States of America

Find articles by Satthawiwat, N. in: PubMed | Google Scholar

1Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

2Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, United States of America

3Division of Pediatric Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

4Immune Monitoring Core, Mayo Clinic, Rochester, United States of America

5Department of Cellular and Molecular Medicine, University of California San Diego School of Medicine, La Jolla, United States of America

6Department of Surgery, University of California San Diego School of Medicine, La Jolla, United States of America

7Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, United States of America

8Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, Mayo Clinic, Rochester, United States of America

Find articles by Hamdi, A. in: PubMed | Google Scholar

1Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

2Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, United States of America

3Division of Pediatric Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

4Immune Monitoring Core, Mayo Clinic, Rochester, United States of America

5Department of Cellular and Molecular Medicine, University of California San Diego School of Medicine, La Jolla, United States of America

6Department of Surgery, University of California San Diego School of Medicine, La Jolla, United States of America

7Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, United States of America

8Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, Mayo Clinic, Rochester, United States of America

Find articles by Hmaydoosh, G. in: PubMed | Google Scholar

1Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

2Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, United States of America

3Division of Pediatric Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

4Immune Monitoring Core, Mayo Clinic, Rochester, United States of America

5Department of Cellular and Molecular Medicine, University of California San Diego School of Medicine, La Jolla, United States of America

6Department of Surgery, University of California San Diego School of Medicine, La Jolla, United States of America

7Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, United States of America

8Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, Mayo Clinic, Rochester, United States of America

Find articles by Dai, X. in: PubMed | Google Scholar

1Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

2Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, United States of America

3Division of Pediatric Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

4Immune Monitoring Core, Mayo Clinic, Rochester, United States of America

5Department of Cellular and Molecular Medicine, University of California San Diego School of Medicine, La Jolla, United States of America

6Department of Surgery, University of California San Diego School of Medicine, La Jolla, United States of America

7Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, United States of America

8Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, Mayo Clinic, Rochester, United States of America

Find articles by Yaqoob, U. in: PubMed | Google Scholar |

1Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

2Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, United States of America

3Division of Pediatric Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

4Immune Monitoring Core, Mayo Clinic, Rochester, United States of America

5Department of Cellular and Molecular Medicine, University of California San Diego School of Medicine, La Jolla, United States of America

6Department of Surgery, University of California San Diego School of Medicine, La Jolla, United States of America

7Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, United States of America

8Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, Mayo Clinic, Rochester, United States of America

Find articles by Pavelko, K. in: PubMed | Google Scholar |

1Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

2Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, United States of America

3Division of Pediatric Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

4Immune Monitoring Core, Mayo Clinic, Rochester, United States of America

5Department of Cellular and Molecular Medicine, University of California San Diego School of Medicine, La Jolla, United States of America

6Department of Surgery, University of California San Diego School of Medicine, La Jolla, United States of America

7Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, United States of America

8Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, Mayo Clinic, Rochester, United States of America

Find articles by Miciano, C. in: PubMed | Google Scholar

1Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

2Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, United States of America

3Division of Pediatric Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

4Immune Monitoring Core, Mayo Clinic, Rochester, United States of America

5Department of Cellular and Molecular Medicine, University of California San Diego School of Medicine, La Jolla, United States of America

6Department of Surgery, University of California San Diego School of Medicine, La Jolla, United States of America

7Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, United States of America

8Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, Mayo Clinic, Rochester, United States of America

Find articles by Kisseleva, T. in: PubMed | Google Scholar

1Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

2Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, United States of America

3Division of Pediatric Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

4Immune Monitoring Core, Mayo Clinic, Rochester, United States of America

5Department of Cellular and Molecular Medicine, University of California San Diego School of Medicine, La Jolla, United States of America

6Department of Surgery, University of California San Diego School of Medicine, La Jolla, United States of America

7Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, United States of America

8Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, Mayo Clinic, Rochester, United States of America

Find articles by Firdaus, Z. in: PubMed | Google Scholar

1Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

2Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, United States of America

3Division of Pediatric Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

4Immune Monitoring Core, Mayo Clinic, Rochester, United States of America

5Department of Cellular and Molecular Medicine, University of California San Diego School of Medicine, La Jolla, United States of America

6Department of Surgery, University of California San Diego School of Medicine, La Jolla, United States of America

7Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, United States of America

8Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, Mayo Clinic, Rochester, United States of America

Find articles by Starlinger, P. in: PubMed | Google Scholar

1Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

2Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, United States of America

3Division of Pediatric Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

4Immune Monitoring Core, Mayo Clinic, Rochester, United States of America

5Department of Cellular and Molecular Medicine, University of California San Diego School of Medicine, La Jolla, United States of America

6Department of Surgery, University of California San Diego School of Medicine, La Jolla, United States of America

7Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, United States of America

8Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, Mayo Clinic, Rochester, United States of America

Find articles by Pereyra, D. in: PubMed | Google Scholar

1Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

2Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, United States of America

3Division of Pediatric Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

4Immune Monitoring Core, Mayo Clinic, Rochester, United States of America

5Department of Cellular and Molecular Medicine, University of California San Diego School of Medicine, La Jolla, United States of America

6Department of Surgery, University of California San Diego School of Medicine, La Jolla, United States of America

7Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, United States of America

8Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, Mayo Clinic, Rochester, United States of America

Find articles by Kostallari, E. in: PubMed | Google Scholar |

1Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

2Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, United States of America

3Division of Pediatric Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

4Immune Monitoring Core, Mayo Clinic, Rochester, United States of America

5Department of Cellular and Molecular Medicine, University of California San Diego School of Medicine, La Jolla, United States of America

6Department of Surgery, University of California San Diego School of Medicine, La Jolla, United States of America

7Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, United States of America

8Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, Mayo Clinic, Rochester, United States of America

Find articles by Hirsova, P. in: PubMed | Google Scholar |

1Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

2Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, United States of America

3Division of Pediatric Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

4Immune Monitoring Core, Mayo Clinic, Rochester, United States of America

5Department of Cellular and Molecular Medicine, University of California San Diego School of Medicine, La Jolla, United States of America

6Department of Surgery, University of California San Diego School of Medicine, La Jolla, United States of America

7Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, United States of America

8Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, Mayo Clinic, Rochester, United States of America

Find articles by Povero, D. in: PubMed | Google Scholar

1Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

2Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, United States of America

3Division of Pediatric Gastroenterology & Hepatology, Mayo Clinic, Rochester, United States of America

4Immune Monitoring Core, Mayo Clinic, Rochester, United States of America

5Department of Cellular and Molecular Medicine, University of California San Diego School of Medicine, La Jolla, United States of America

6Department of Surgery, University of California San Diego School of Medicine, La Jolla, United States of America

7Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, United States of America

8Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, Mayo Clinic, Rochester, United States of America

Find articles by Ibrahim, S. in: PubMed | Google Scholar |

Published May 5, 2026 - More info

JCI Insight. https://doi.org/10.1172/jci.insight.202552.
Copyright © 2026, Sano 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 May 5, 2026 - Version history
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Abstract

In metabolic dysfunction-associated steatohepatitis (MASH), liver sinusoidal endothelial cells (LSECs) acquire a proinflammatory phenotype termed lipotoxic endotheliopathy. We previously identified glycogen synthase kinase 3β (GSK3β) as a central signaling hub in LSECs during MASH. To elucidate the molecular mechanisms and functional outcome of lipotoxicity-induced GSK3β activation in LSECs, we utilized endothelial cell-specific Gsk3β knockout (Gsk3β△End) mice fed MASH-inducing diets. Endothelial Gsk3β deletion significantly reduced markers of lipotoxic endotheliopathy, including adhesion molecules and chemokines, alongside liver injury, inflammation, and fibrosis. Immune profiling via flow cytometry and mass cytometry by time of flight (CyTOF) identified decreased hepatic infiltration of proinflammatory myeloid populations, particularly mature dendritic cells (DCs) in Gsk3β△End mice. In a co-culture system, GSK3β in lipotoxic LSECs promoted DCs maturation. Mechanistically, GSK3 inhibition restored lipotoxicity-induced alterations in LSEC mitochondrial morphology and respiration by regulating AMP-activated protein kinase and dynamin-related protein 1. This rescue suppressed chemokines and adhesion molecules expression, thereby limiting immune cell recruitment. Collectively, under lipotoxic stress, GSK3β amplifies mitochondrial dysfunction and inflammatory signaling in LSECs, enhancing myeloid cell homing and DC maturation. Targeting LSEC GSK3β may therefore represent a promising therapeutic strategy to mitigate LSEC driven fibro inflammatory response in human MASH.

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