Hepatic ADMA–PRMT1 axis regulation is associated with NO-dependent endothelial dysfunction in MASH

Metabolic dysfunction-associated steatohepatitis (MASH) is a severe form of fatty liver disease and a recognized cardiovascular risk factor, yet the mechanisms linking hepatic pathology to vascular dysfunction remain poorly understood. We aimed to investigate whether MASH impairs endothelial function via nitric oxide (NO)-dependent mechanisms and to identify potential liver-derived mediators involved in this process.

Endothelial function was assessed in two murine MASH models, Foz mice fed a high-fat diet and C57BL/6JRj mice fed a western diet with fructose, by using wire myography, while blood pressure was monitored via telemetry. NO pathway was further investigated through eNOS expression and activation and Hb-NO measurements. ADMA metabolism was analyzed in both liver tissue and plasma by LC-MS and gene expressions. Additionally, bovine aortic endothelial cells (BAECs) were treated with mouse plasma to measure the circulating factors’ effects on eNOS activation and the role of oxidative stress.

Both models exhibited impaired NO-dependent vasorelaxation without evidence of atherosclerosis. In Foz mice, this impairment was associated with reduced eNOS expression and activation. Surprisingly, plasma Hb-NO levels did not reflect vascular NO deficiency, likely due to elevated hepatic iNOS expression. In both models, hepatic and plasma ADMA levels were increased, concomitant with hepatic upregulation of Prmt1 . BAECs exposed to plasma from MASH mice showed reduced eNOS activation independent of oxidative stress.

Our findings reveal that MASH is consistently associated with NO-dependent endothelial dysfunction, with ADMA emerging as a key liver-derived mediator. The PRMT1/ADMA/NO axis may represent a mechanistic link between liver pathology and vascular impairment, positioning ADMA as a potential biomarker and therapeutic target for cardiovascular risk associated with MASH.

Highlights

• MASH is associated with impaired NO-dependent endothelial function in two distinct MASH models.

• Circulating factors disrupt the NOS/NO pathway independently of oxidative stress

• Reduced plasma Hb-NO levels do not accurately reflect NO-dependent endothelial dysfunction in a context of MASH.

• Elevated plasma and hepatic ADMA levels associated with hepatic prmt1 upregulation are consistently observed in both MASH models.

• The PRMT1/ADMA/NO axis emerges as a key liver-mediated mechanism driving endothelial dysfunction in MASH