The Integrated “Multiomics” Landscape at Peak Injury and Resolution From Alcohol‐Associated Liver Disease

Alcohol‐associated liver disease (ALD) is a significant clinical problem for which the most effective therapy is alcohol abstinence. The two aims of this study were, first, to identify the liver transcriptome, fecal microbiome, and portal serum metabolome at peak injury and during early and late resolution from ALD; and second, to integrate their interactions and understand better the pathogenesis of ALD. To provoke alcohol‐induced liver injury, female and male wild‐type mice were fed the control or ethanol Lieber‐DeCarli diets for 6 weeks. To study early and late resolution, alcohol was withdrawn from the diet and mice were sacrificed after 3 and 14 days, respectively. At peak injury, there was increased signal transducer and activator of transcription (Stat3), Rho‐GTPases, Tec kinase and glycoprotein VI (Gp6), and decreased peroxisome proliferator–activated receptor signaling. During resolution from ALD, there was up‐regulation of vitamin D receptor/retinoid X receptor, toll‐like receptor, p38 and Stat3, and down‐regulation of liver X receptor signaling. Females showed significant changes in catabolic pathways, whereas males increased cellular stress, injury, and immune‐response pathways that decreased during resolution. The bacterial genus Alistipes and the metabolite dipeptide glycyl‐L‐leucine increased at peak but decreased during resolution from ALD in both genders. Hepatic induction of mitogen‐activated protein kinase (Map3k1) correlated with changes in the microbiome and metabolome at peak but was restored during ALD resolution. Inhibition of MAP3K1 protected from ALD in mice. Conclusion: Alcohol abstinence restores the liver transcriptome, fecal microbiome, and portal serum metabolome in a gender‐specific manner. Integration of multiomics data identified Map3k1 as a key gene driving pathogenesis and resolution from ALD.