Membrane-bound O-acyltransferase 7 (MBOAT7) shapes lysosomal lipid homeostasis and function to control alcohol-associated liver injury

  1. Venkateshwari Varadharajan
  2. Iyappan Ramachandiran
  3. William J Massey
  4. Raghav Jain
  5. Rakhee Banerjee
  6. Anthony J Horak
  7. Megan R McMullen
  8. Emily Huang
  9. Annette Bellar
  10. Shuhui W Lorkowski
  11. Kailash Gulshan
  12. Robert N Helsley
  13. Isabella James
  14. Vai Pathak
  15. Jaividhya Dasarathy
  16. Nicole Welch
  17. Srinivasan Dasarathy
  18. David Streem
  19. Ofer Reizes
  20. Daniela S Allende
  21. Jonathan D Smith
  22. Judith Simcox
  23. Laura E Nagy
  24. J Mark Brown  Is a corresponding author
  1. Department of Cancer Biology, Lerner Research Institute of the Cleveland Clinic, United States
  2. Center for Microbiome and Human Health, Lerner Research Institute, Cleveland Clinic, United States
  3. Northern Ohio Alcohol Center (NOAC), Lerner Research Institute, Cleveland Clinic, United States
  4. Department of Biochemistry, University of Wisconsin-Madison, United States
  5. Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, United States
  6. Department of Cardiovascular and Metabolic Sciences, Lerner Research Institute of the Cleveland Clinic, United States
  7. Center for Gene Regulation in Health and Disease (GRHD), Cleveland State University, United States
  8. Department of Pharmacology & Nutritional Sciences, Saha Cardiovascular Research Center, University of Kentucky College of Medicine, United States
  9. Department of Family Medicine, Metro Health Medical Center, Case Western Reserve University, United States
  10. Lutheran Hospital, Cleveland Clinic, United States
  11. Department of Anatomical Pathology, Cleveland Clinic, United States
4 figures, 1 table and 2 additional files

Figures

MBOAT7 products are selectively reduced in heavy drinkers.

Plasma lysophosphatidylinositol (LPI – inset graph) and phosphatidylinositol (PI) species from both male and female healthy controls and heavy drinkers were measured by liquid chromatography–tandem mass spectrometry (LC–MS/MS). n = 10–16; ***p < 0.001 and ****p < 0.0001 in the figure. Analysis of variance (ANOVA) with Tukey’s post hoc test.

Figure 1—source data 1

Demographic and clinical parameters for the entire cohort of healthy controls and heavy drinkers recruited for this study.

https://cdn.elifesciences.org/articles/92243/elife-92243-fig1-data1-v1.docx
Figure 2 with 1 supplement
Hepatocyte-specific deletion of Mboat7 promotes ethanol-induced liver injury.

Female control (Mboat7fl/fl) or hepatocyte-specific Mboat7 knockout mice (Mboat7-HSKO) were fed with subjected the NIAAA (National Institute on Alcohol Abuse and Alcoholism) model of ethanol-induced liver injury. (A) Hepatic Mboat7 expression was measured via quantitative polymerase chain reaction (qPCR). (B) Western blot for hepatic microsomal MBOAT7 protein levels replicated in n = 3 mice. (C) Liver weight, (D) plasma alanine aminotransferase (ALT), (E) percent steatosis quantified by a blinded board-certified pathologist, (F) hepatic triglycerides, and (G) hepatic expression of inflammatory gene measured by qPCR. n = 5–7. Data represent the mean ± standard error of the mean (SEM) and groups not sharing a common letter superscript differ significantly (p ≤ 0.05).

Figure 2—source data 1

Original file for the western blot analysis in Figure 2B (anti-MBOAT7 and anti-β-actin).

https://cdn.elifesciences.org/articles/92243/elife-92243-fig2-data1-v1.zip
Figure 2—source data 2

PDF containing Figure 2B and original scans of the relevant western blot analysis (anti-MBOAT7 and anti-β-actin) with highlighted bands and sample labels.

https://cdn.elifesciences.org/articles/92243/elife-92243-fig2-data2-v1.zip
Figure 2—figure supplement 1
Myeloid-specific deletion of Mboat7 does not promote ethanol-induced liver injury.

Female control (Mboat7fl/fl) or myeloid-specific Mboat7 knockout mice (Mboat7-MSKO) were subjected to the NIAAA model of ethanol-induced liver injury. (A) Western blots from bone marrow derived macrophage (BMDM) or peritoneal macrophage (PM) collected from Mboat7fl/fl or Mboat7-MSKO mice. (B) Initial and final body weight measured in Mboat7fl/fl or Mboat7-MSKO mice. (C) Liver weight, (D, E) plasma alanine aminotransferase (ALT) and aspartate aminotransferase (AST), (F) hepatic triglycerides, and (G) hepatic expression of inflammatory gene measured by qPCR. Data represent the mean ± standard error of the mean (SEM) and groups not sharing a common letter superscript differ significantly (p ≤ 0.05).

Figure 2—figure supplement 1—source data 1

Original file for the western blot analysis in Figure 2A (anti-MBOAT7 and anti-β-actin).

https://cdn.elifesciences.org/articles/92243/elife-92243-fig2-figsupp1-data1-v1.zip
Figure 2—figure supplement 1—source data 2

PDF containing Figure 2A and original scans of the relevant western blot analysis (anti-MBOAT7 and anti-β-actin) with highlighted bands and sample labels.

https://cdn.elifesciences.org/articles/92243/elife-92243-fig2-figsupp1-data2-v1.zip
Figure 3 with 11 supplements
Ethanol alters the liver lipidome in a MBOAT7-dependent manner.

Mboat7fl/fl or Mboat7-HSKO mice were subjected to the NIAAA model of ethanol exposure. Liver lysophosphatidylinositol (LPI) (A) and phosphatidylinositol (PI) species, including the MBOAT7 product PI 38:4 (B) and others (C), were quantified via liquid chromatography–tandem mass spectrometry (LC–MS/MS) in n = 5–7. (D) Principal component analysis for untargeted lipidomics analysis. The first and second principal components are plotted on the x- and y-axis, respectively, and sample treatment group is indicated by color. (E) Heatmap showing global lipidomic alterations in mouse liver. Total levels of endosomal/lysosomal lipids were measured by targeted and untargeted lipidomic approach using LC–MS/MS. (F) Total bis(monoacylglycero)phosphate (BMP) levels. (G) Total phosphatidylglycerol (PG) and (H) total cardiolipin (CL) from the liver of Mboat7fl/fl or Mboat7-HSKO mice. Data represent the mean ± standard error of the mean (SEM) and groups not sharing a common letter superscript differ significantly (p ≤ 0.05).

Figure 3—figure supplement 1
Alterations in total hepatic lipid levels in Mboat7-HSKO mice.

Age-matched female Mboat7fl/fl or Mboat7-HSKO mice were subjected to the NIAAA model of ethanol exposure, and untargeted lipidomics was performed to broadly examine major lipid classes in the liver. (A) Phosphatidylcholine (PC), (B) phosphatidylserine (PS), (C) phosphatidylethanolamine (PE), (D) phosphatidic acid (PA), (E) sphingomyelins (SM), (F) ceramides (Cer), (G) ether phosphatidylcholine, (H) ether phosphatidylethanolamine, (I) free fatty acids (FFA), (J) hexosylceramide (HexCer), (K) diacylglycerol (DAG), and (L) cholesteryl ester (CE) were quantified via liquid chromatography–mass spectrometry (n = 6/group). Data represent the mean ± standard error of the mean (SEM) and groups not sharing a common letter superscript differ significantly (p ≤ 0.05).

Figure 3—figure supplement 2
Hepatic phosphatidylcholine (PC) levels in Mboat7-HSKO mice.

Age-matched female Mboat7fl/fl or Mboat7-HSKO mice were subjected to the NIAAA model of ethanol exposure, and untargeted lipidomics were performed to broadly examine major lipid classes in the liver. The molecular species of PC were quantified via liquid chromatography–mass spectrometry (n = 6/group). Data represent the mean ± standard error of the mean (SEM) and groups not sharing a common letter superscript differ significantly (p ≤ 0.05).

Figure 3—figure supplement 3
Hepatic bis(monoacylglycerol)phosphate (BMP) levels in Mboat7-HSKO mice.

Age-matched female Mboat7fl/fl or Mboat7-HSKO mice were subjected to the NIAAA model of ethanol exposure, and targeted lipidomics was performed in the liver. The molecular species of BMP were quantified via liquid chromatography–mass spectrometry (n = 6/group). Data represent the mean ± standard error of the mean (SEM) and groups not sharing a common letter superscript differ significantly (p ≤ 0.05).

Figure 3—figure supplement 4
Hepatic phosphatidylglycerol (PG) levels in Mboat7-HSKO mice.

Age-matched female Mboat7fl/fl or Mboat7-HSKO mice were subjected to the NIAAA model of ethanol exposure, and targeted lipidomics was performed in the liver. The molecular species of PG were quantified via liquid chromatography–mass spectrometry (n = 6/group). Data represent the mean ± standard error of the mean (SEM) and groups not sharing a common letter superscript differ significantly (p ≤ 0.05).

Figure 3—figure supplement 5
Hepatic cardiolipin (CL) levels in Mboat7-HSKO mice.

Age-matched female Mboat7fl/fl or Mboat7-HSKO mice were subjected to the NIAAA model of ethanol exposure, and untargeted lipidomics was performed in the liver. The molecular species of CL were quantified via liquid chromatography–mass spectrometry (n = 6/group). Data represent the mean ± standard error of the mean (SEM) and groups not sharing a common letter superscript differ significantly (p ≤ 0.05).

Figure 3—figure supplement 6
Hepatic phosphatidylserine (PS) levels in Mboat7-HSKO mice.

Age-matched female Mboat7fl/fl or Mboat7-HSKO mice were subjected to the NIAAA model of ethanol exposure, and untargeted lipidomics was performed in the liver. The molecular species of PS were quantified via liquid chromatography–mass spectrometry (n = 6/group). Data represent the mean ± standard error of the mean (SEM) and groups not sharing a common letter superscript differ significantly (p ≤ 0.05).

Figure 3—figure supplement 7
Hepatic phosphatidylethanolamine (PE) levels in Mboat7-HSKO mice.

Age-matched female Mboat7fl/fl or Mboat7-HSKO mice were subjected to the NIAAA model of ethanol exposure, and untargeted lipidomics was performed in the liver. The molecular species of PE were quantified via liquid chromatography–mass spectrometry (n = 6/group). Data represent the mean ± standard error of the mean (SEM) and groups not sharing a common letter superscript differ significantly (p ≤ 0.05).

Figure 3—figure supplement 8
Hepatic phosphatidic acid (PA) levels in Mboat7-HSKO mice.

Age-matched female Mboat7fl/fl or Mboat7-HSKO mice were subjected to the NIAAA model of ethanol exposure, and untargeted lipidomics was performed in the liver. The molecular species of PA were quantified via liquid chromatography–mass spectrometry (n = 6/group). Data represent the mean ± standard error of the mean (SEM) and groups not sharing a common letter superscript differ significantly (p ≤ 0.05).

Figure 3—figure supplement 9
Hepatic sphingomyelin (SM) levels in Mboat7-HSKO mice.

Age-matched female Mboat7fl/fl or Mboat7-HSKO mice were subjected to the NIAAA model of ethanol exposure, and untargeted lipidomics was performed in the liver. The molecular species of SM were quantified via liquid chromatography–mass spectrometry (n = 6/group). Data represent the mean ± standard error of the mean (SEM) and groups not sharing a common letter superscript differ significantly (p ≤ 0.05).

Figure 3—figure supplement 10
Hepatic ceramide (Cer) levels in Mboat7-HSKO mice.

Age-matched female Mboat7fl/fl or Mboat-HSKO mice were subjected to the NIAAA model of ethanol exposure, and untargeted lipidomics was performed in the liver. The molecular species of ceramides were quantified via liquid chromatography–mass spectrometry (n = 6/group). Data represent the mean ± standard error of the mean (SEM) and groups not sharing a common letter superscript differ significantly (p ≤ 0.05).

Figure 3—figure supplement 11
Hepatic ether-linked lipids levels in Mboat7-HSKO mice.

Age-matched female Mboat7fl/fl or Mboat7-HSKO mice were subjected to the NIAAA model of ethanol exposure, and untargeted lipidomics was performed in the liver. The molecular species of ether-linked lipids were quantified via liquid chromatography–mass spectrometry (n = 6/group). Data represent the mean ± standard error of the mean (SEM) and groups not sharing a common letter superscript differ significantly (p ≤ 0.05).

Figure 4 with 2 supplements
Mboat7-HSKO mice have dysregulated lysosome function in response to ethanol.

Age-matched female Mboat7fl/fl or Mboat7-HSKO mice were subjected to the NIAAA model of ethanol exposure. (A) Total liver lysates were subjected to western blot analysis of major autophagy marker genes LC3A/B (P62), mammalian target of rapamycin (mTOR) and lysosome biogenesis genes (TFEB, LAMP-1, LAMP-2, and ATP6V1A). (B) Nuclear fractions from mouse livers of Mboat7fl/fl and Mboat7-HSKO were subjected to western blot analysis of TFEB. (C) Lysosome protein degradation activity in wild-type and MBOAT7∆-Huh7 hepatoma cells treated with or without 100 mM ethanol for 48 hr was assessed by incubating cells with 10 µg/ml of lysosome indicator for 2 hr and examined by flow cytometry. n = 5 from two experiments by normalizing to wild-type group in each experiment; mean ± standard deviation (SD) (D) Expression levels of the genes encoding functions in lysosomal hydrolase and accessory, lysosomal m involved in lysosomal biogenesis in the liver of Mboat7fl/fl and Mboat7-HSKO mice upon ethanol feeding. mRNA expression levels were determined by qPCR (n = 6/group). Groups not sharing a common letter superscript differ significantly (p ≤ 0.05).

Figure 4—source data 1

Original file for the western blot analysis in Figure 4A (anti-LC3-A/B).

https://cdn.elifesciences.org/articles/92243/elife-92243-fig4-data1-v1.zip
Figure 4—source data 2

Original file for the western blot analysis in Figure 4A (anti-p62).

https://cdn.elifesciences.org/articles/92243/elife-92243-fig4-data2-v1.zip
Figure 4—source data 3

Original file for the western blot analysis in Figure 4A (anti-Total mTOR and anti-LAMP-1).

https://cdn.elifesciences.org/articles/92243/elife-92243-fig4-data3-v1.zip
Figure 4—source data 4

Original file for the western blot analysis in Figure 4A (anti-TFEB).

https://cdn.elifesciences.org/articles/92243/elife-92243-fig4-data4-v1.zip
Figure 4—source data 5

Original file for the western blot analysis in Figure 4A (anti-LAMP-2 and anti-ATP6V1A).

https://cdn.elifesciences.org/articles/92243/elife-92243-fig4-data5-v1.zip
Figure 4—source data 6

Original file for the western blot analysis in Figure 4A (anti-β-actin).

https://cdn.elifesciences.org/articles/92243/elife-92243-fig4-data6-v1.zip
Figure 4—source data 7

PDF containing Figure 4A and original scans of the relevant western blot analysis (anti-MBOAT7, anti-p62, anti-total mTOR, anti-total TFEB, anti-LAMP-1, anti-LAMP-2, anti-ATP6V1A, and anti-β-actin) with highlighted bands and sample labels.

https://cdn.elifesciences.org/articles/92243/elife-92243-fig4-data7-v1.zip
Figure 4—source data 8

Original file for the western blot analysis in Figure 4B (anti-cytosolic-TFEB).

https://cdn.elifesciences.org/articles/92243/elife-92243-fig4-data8-v1.zip
Figure 4—source data 9

Original file for the western blot analysis in Figure 4B (anti-nuclear TFEB).

https://cdn.elifesciences.org/articles/92243/elife-92243-fig4-data9-v1.zip
Figure 4—source data 10

Original file for the western blot analysis in Figure 4B (anti-LAMIN A/C).

https://cdn.elifesciences.org/articles/92243/elife-92243-fig4-data10-v1.zip
Figure 4—source data 11

Original file for the western blot analysis in Figure 4B (anti-GAPDH).

https://cdn.elifesciences.org/articles/92243/elife-92243-fig4-data11-v1.zip
Figure 4—source data 12

PDF containing Figure 4B and original scans of the relevant western blot analysis (anti-cytosolic TFEB, anti-nuclear TFEB, anti-LAMIN A/C, and anti-GAPDH) with highlighted bands and sample labels.

https://cdn.elifesciences.org/articles/92243/elife-92243-fig4-data12-v1.zip
Figure 4—figure supplement 1
Genetic deletion of MBOAT7 in human Huh7 cells is associated with diminished lysosome biogenesis and ethanol-induced autophagy dysregulation.

WT and MBOAT7Δ Huh7 hepatoma cells were treated with and without ethanol treatment (100 mM) for 24 (A) and 48 hr (B). Total lysate were subjected to western blot analysis of LC3A/B, P62, Total mTOR, Total TFEB, LAMP-1, LAMP-2, and ATP6V1A.

Figure 4—figure supplement 1—source data 1

Original file for the western blot analysis in Figure 4A, B (anti-LC3-A/B).

https://cdn.elifesciences.org/articles/92243/elife-92243-fig4-figsupp1-data1-v1.zip
Figure 4—figure supplement 1—source data 2

Original file for the western blot analysis in Figure 4A and B (anti-p62).

https://cdn.elifesciences.org/articles/92243/elife-92243-fig4-figsupp1-data2-v1.zip
Figure 4—figure supplement 1—source data 3

Original file for the western blot analysis in Figure 4A and B (anti-Total mTOR and anti-LAMP-1).

https://cdn.elifesciences.org/articles/92243/elife-92243-fig4-figsupp1-data3-v1.zip
Figure 4—figure supplement 1—source data 4

Original file for the western blot analysis in Figure 4A and B (anti-TFEB).

https://cdn.elifesciences.org/articles/92243/elife-92243-fig4-figsupp1-data4-v1.zip
Figure 4—figure supplement 1—source data 5

Original file for the western blot analysis in Figure 4A and B (anti-LAMP-2 and anti-ATP6V1A).

https://cdn.elifesciences.org/articles/92243/elife-92243-fig4-figsupp1-data5-v1.zip
Figure 4—figure supplement 1—source data 6

Original file for the western blot analysis in Figure 4A and B (anti-β-actin).

https://cdn.elifesciences.org/articles/92243/elife-92243-fig4-figsupp1-data6-v1.zip
Figure 4—figure supplement 1—source data 7

PDF containing Figure 4A and B and original scans of the relevant western blot analysis (anti-MBOAT7, anti-p62, anti-total mTOR, anti-total TFEB, anti-LAMP-1, anti-LAMP-2, anti-ATP6V1A, and anti-β-actin) with highlighted bands and sample labels.

https://cdn.elifesciences.org/articles/92243/elife-92243-fig4-figsupp1-data7-v1.zip
Figure 4—figure supplement 2
Working model.

MBOAT7 loss of function in either mouse or human hepatocytes is associated with decreased transcription factor EB (TFEB)-driven lysosomal biogenesis and defective autophagy secondary to lysosomal dysfunction.

Tables

Key resources table
Reagent type (species) or resourceDesignationSource or referenceIdentifiersAdditional information
Genetic reagent (M. musculus)Mboat7tm1a(KOMP)Wtsi/Mboat7tm1a(KOMP)WtsiPMID:23472195RRID: MGI:5510874
Genetic reagent (M. musculus)B6N.Cg-Speer6-ps1Tg(Alb-cre)21Mgn/JJackson LaboratoryStock#: 018961
RRID: IMSR_JAX:018961
Genetic reagent (M. musculus)B6.129P2-Lyz2tm1(cre)Ifo/JJackson LaboratoryStock#: 004781
RRID: IMSR_JAX:004781
Cell line (Homo sapiens)HUH7 (well differentiated human hepatocellular carcinoma)Japanese Collection of Research Biosources Cell BankJCRB0403
AntibodyAnti-MBOAT7 (Rat monoclonal)PMID:23097495RRID: AB_2813851WB (1:1000)
AntibodyAnti-rat IgG HRP secondary antibodyCell SignalingCat#: 7077
RRID: AB_10694715
WB (1:5000)
AntibodyLC3A/B (D3U4C) XP (Rabbit monoclonal)Cell SignalingCat#: 12741
RRID: AB_2617131
WB (1:1000)
AntibodySQSTM1/p62 (Rabbit polyclonal)Cell SignalingCat#: 5114
RRID: AB_10624872
WB (1:1000)
AntibodymTOR (7C10) (Rabbit monoclonal)Cell SignalingCat#: 2983
RRID: AB_2105622
WB (1:1000)
AntibodyTFEB (D2O7D) (Rabbit monoclonal)Cell SignalingCat#: 37785WB (1:1000)
AntibodyTFEB (Rabbit polyclonal)Thermo Fisher ScientificCat#: A303-673A
RRID: AB_11204751
WB (1:1000)
AntibodyLAMP1 (D2D11) XP Rabbit monoclonalCell SignalingCat#: 9091
RRID: AB_2687579
WB (1:1000)
AntibodyLAMP-1 (Rat monoclonal)Developmental Studies Hybridoma Bank (DSHB)Cat#: ID4B
RRID: AB_528127
WB (1:1000)
AntibodyLAMP-2 (Rat monoclonal)Developmental Studies Hybridoma Bank (DSHB)Cat#: ABL-93
RRID: AB_2134767
WB (1:1000)
AntibodyLAMP2 (D5C2P) (Rabbit monoclonal)Cell SignalingCat#: 49067
RRID: AB_2799349
WB (1:1000)
AntibodyATP6V1A (Rabbit polyclonal)GeneTexCat#: GTX110815
RRID: AB_1949704
WB (1:1000)
antibodyAnti-GAPDH-HRP (Rabbit monoclonal)Cell SignalingCat#: 8884
RRID: AB_11129865
WB (1:5000)
AntibodyLamin A/C (4C11) (Mouse monoclonal)Cell SignalingCat#: 4777WB (1:1000)
AntibodyHRP-conjugated Beta Actin (Mouse monoclonal)ProteintechCat#: HRP-60008
RRID: AB_2289225
WB (1:10,000)
Commercial assay or kitAlanine Aminotransaminase (ALT) kitSekisui Diagnostics318-30
Commercial assay or kitAspartate Aminotransferase (AST) kitSekisui Diagnostics319-30
Commercial assay or kitLiver TriglycerideWako994-02891
Commercial assay or kitMicrosome IsolationAbcamab206995
Commercial assay or kitNE-PER Nuclear and Cytoplasmic Extraction ReagentsThermo Fisher
Scientific
78833
Commercial assay or kitSupersignal West Pico Plus substrateThermo Fisher
Scientific
34577
Chemical compound, drugAmmonium formateHoneywellCat# 55674
Chemical compound, drugMethanolHoneywellCat# LC230-4
Chemical compound, drugWaterHoneywellCat# LC365-4
Chemical compound, drugAcetonitrileHoneywellCat# LC015-4
Chemical compound, drugIsopropanolFisher ScientificCat# A461-4
Chemical compound, drugEthyl acetateSigma-AldrichCat# 650528
Chemical compound, drugFormic acidThermo ScientificCat# 28905
Chemical compound, drugFA 18:0d35Cayman ChemicalCat# 9003318
Chemical compound, drugACar 18:1d3Cayman ChemicalCat# 26578
Chemical compound, drugBMP 14:0_14:0AvantiCat# 857131
Chemical compound, drugPG 15:0_18:1d7AvantiCat# 91640
Chemical compound, drugCer d18:1d7_15:0AvantiCat# 860681P
Chemical compound, drugPA 15:0_18:1d7AvantiCat# 791642
Chemical compound, drugSPLASH LipidoMix IIAvantiCat# 330709
Chemical compound, drugBMP 18:1_18:1AvantiCat# 857133P
Chemical compound, drugPG 18:1_18:1AvantiCat# 840475P

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  1. Venkateshwari Varadharajan
  2. Iyappan Ramachandiran
  3. William J Massey
  4. Raghav Jain
  5. Rakhee Banerjee
  6. Anthony J Horak
  7. Megan R McMullen
  8. Emily Huang
  9. Annette Bellar
  10. Shuhui W Lorkowski
  11. Kailash Gulshan
  12. Robert N Helsley
  13. Isabella James
  14. Vai Pathak
  15. Jaividhya Dasarathy
  16. Nicole Welch
  17. Srinivasan Dasarathy
  18. David Streem
  19. Ofer Reizes
  20. Daniela S Allende
  21. Jonathan D Smith
  22. Judith Simcox
  23. Laura E Nagy
  24. J Mark Brown
(2024)
Membrane-bound O-acyltransferase 7 (MBOAT7) shapes lysosomal lipid homeostasis and function to control alcohol-associated liver injury
eLife 12:RP92243.
https://doi.org/10.7554/eLife.92243.3