Loss of hepatocyte-specific RECK exacerbates metabolic dysfunction-associated steatohepatitis.

Metabolic dysfunction-associated steatohepatitis (MASH) continues to be a major health crisis worldwide due to increases in obesity and insulin resistance. The role of the extracellular matrix regulator reversion-inducing cysteine-rich protein with Kazal motifs (RECK) in metabolic liver disease is poorly understood. We previously reported that RECK gain-of-function, specifically in hepatocytes, protects against diet-induced MASH. Here, we hypothesized that hepatocyte-specific RECK loss-of-function exacerbates liver injury in a preclinical model of diet-induced MASH. Using two novel mouse models of hepatocyte-specific RECK depletion, we demonstrate that RECK gene deletion significantly increased inflammation, ballooning, and fibrosis in the liver. Transcriptomic and proteomic analysis supported these findings, revealing gene/protein networks associated with inflammation and fibrosis. Targeted assessment revealed that RECK depletion results in elevated hepatic mRNA levels of several genes associated with inflammation, extracellular matrix remodeling, and fibrogenesis. Furthermore, levels of phosphorylated epidermal growth factor receptor (EGFR) and its ligand amphiregulin (AREG) were also increased with RECK germline deletion, suggesting a potential link between RECK and EGFR activity. These studies reveal RECK as a critical regulator of hepatic inflammation and fibrosis and highlight its potential as a novel therapeutic in MASH.NEW & NOTEWORTHY Deletion of the RECK gene in hepatocytes induced hepatic injury in preclinical models of diet-induced MASH. Transcriptomic and proteomic analysis revealed enrichment of pathways involved in liver inflammation and fibrotic remodeling. Targeted assessment validated multi-omic findings, showing an increase in genes associated with inflammation, extracellular matrix remodeling, and fibrosis with loss of RECK. These studies reveal RECK as a critical regulator of hepatic inflammation and fibrosis and underscore its potential as novel therapeutic in MASH.