Enoyl coenzyme A hydratase 1 alleviates nonalcoholic steatohepatitis in mice by suppressing hepatic ferroptosis

Nonalcoholic steatohepatitis (NASH) is a common metabolic disorder that is a major contributor to health care expenditures worldwide. Enoyl coenzyme A hydratase 1 (ECH1) is initially recognized as a key component in mitochondrial fatty acid β-oxidation, and subsequent studies have demonstrated that it regulates multiple pathophysiological processes. However, the relationship between ECH1 and NASH has remained largely unknown. Herein, we investigated the role of ECH1 in NASH progression. Adeno-associated virus-mediated genetic engineering was used to investigate the role of ECH1. Alterations in hepatic steatosis, inflammation, fibrogenesis, oxidative stress, apoptosis, and liver injury were monitored using liver or serum samples from mice. ECH1 expression was significantly higher in human NASH biopsy specimens and in methionine choline-deficient (MCD) diet-fed mice. ECH1 overexpression significantly alleviated hepatic steatosis, inflammation, fibrogenesis, apoptosis, and oxidative stress in livers of mice. In addition, ECH1 overexpression also reduced alanine aminotransferase and proinflammatory cytokine levels in serum and triglyceride levels in livers. Consistently, ECH1 knockdown suppressed this beneficial phenotype. Mechanistically, ECH1-knockdown mice treated with ferrostatin-1 (Fer-1) showed an alleviated NASH phenotype compared with the untreated knockdown mice. Meanwhile, we detected changes in Erk signaling pathway when ECH1 was overexpressed or knocked down, which may partially explain the potential mechanism of ECH1 regulation of ferroptosis.In summary, ECH1 may ameliorate steatohepatitis by inhibiting ferroptosis. Pharmacological or genetic ECH1 activation may have potential as a future therapy for NASH.NEW & NOTEWORTHY Enoyl coenzyme A hydratase 1 (ECH1) is a key component in mitochondrial fatty acid β-oxidation and is also a well-known enzyme for lipid metabolism. However, the biological role of ECH1 in the development of NASH is still unclear. Herein, we demonstrated that ECH1 inhibits NASH by inhibiting ferroptosis, thus providing a novel target for therapeutic intervention for future treatment of NASH.