- Todoric, Jelena;
- Di Caro, Giuseppe;
- Reibe, Saskia;
- Henstridge, Darren C;
- Green, Courtney R;
- Vrbanac, Alison;
- Ceteci, Fatih;
- Conche, Claire;
- McNulty, Reginald;
- Shalapour, Shabnam;
- Taniguchi, Koji;
- Meikle, Peter J;
- Watrous, Jeramie D;
- Moranchel, Rafael;
- Najhawan, Mahan;
- Jain, Mohit;
- Liu, Xiao;
- Kisseleva, Tatiana;
- Diaz-Meco, Maria T;
- Moscat, Jorge;
- Knight, Rob;
- Greten, Florian R;
- Lau, Lester F;
- Metallo, Christian M;
- Febbraio, Mark A;
- Karin, Michael
Benign hepatosteatosis, affected by lipid uptake, de novo lipogenesis and fatty acid (FA) oxidation, progresses to non-alcoholic steatohepatitis (NASH) on stress and inflammation. A key macronutrient proposed to increase hepatosteatosis and NASH risk is fructose. Excessive intake of fructose causes intestinal-barrier deterioration and endotoxaemia. However, how fructose triggers these alterations and their roles in hepatosteatosis and NASH pathogenesis remain unknown. Here we show, using mice, that microbiota-derived Toll-like receptor (TLR) agonists promote hepatosteatosis without affecting fructose-1-phosphate (F1P) and cytosolic acetyl-CoA. Activation of mucosal-regenerative gp130 signalling, administration of the YAP-induced matricellular protein CCN1 or expression of the antimicrobial peptide Reg3b (beta) peptide counteract fructose-induced barrier deterioration, which depends on endoplasmic-reticulum stress and subsequent endotoxaemia. Endotoxin engages TLR4 to trigger TNF production by liver macrophages, thereby inducing lipogenic enzymes that convert F1P and acetyl-CoA to FA in both mouse and human hepatocytes.