Myocardial infarction accelerates hepatic pathological progression of NASH by triggering immunoinflammatory response and induction of periostin

Patients with non-alcoholic fatty liver disease (NAFLD), especially advanced non-alcoholic steatohepatitis (NASH), have an increased risk of cardiovascular diseases (CVD) due to the production of pro-inflammatory factors, vasoactive and thrombogenic molecules, or insulin resistance and related disorders. While elevated risk and incidence of CVD events in NAFLD/NASH are well established, whether such events will, in turn, influence the pathogenesis of NAFLD remains unknown. Here, we show that myocardial infarction (MI) accelerates the linear hepatic pathological progression of NAFLD. In humans, NAFLD patients who experienced CVD events after their diagnosis of NAFLD show a rapid progression of hepatic fibrosis. In mouse models of NASH, MI promotes hepatic fibrosis, accompanied by elevated circulating Ly6Chi monocytes and their recruitment to the damaged liver tissues. Depleting these cells abrogate MI-induced hepatic pathological effects in mice with NASH. Meanwhile, MI substantially elevates circulating and cardiac periostin contents, which act on hepatocytes and stellate cells to promote hepatic lipid accumulation and fibrosis, finally exacerbating hepatic pathological progression of NASH. Additionally, specific silence of cardiac periostin markedly attenuates MI-induced hepatic pathological progression of mice with NASH. These preclinical and clinical results demonstrate that MI alternates systemic homeostasis and upregulates the production of pro-fibrotic factors, triggering cross-disease communication that accelerates hepatic pathological progression of NAFLD.