Deep Proteome Profiling of Metabolic Dysfunction-Associated Steatotic Liver Disease

Metabolic dysfunction-associated steatotic liver disease (MASLD) affects roughly 1 in 3 adults and is a leading cause of liver transplants and liver related mortality. A deeper understanding of disease pathogenesis is essential to assist in developing blood-based biomarkers. Here, we use data-independent acquisition mass spectrometry to assess disease-state associated protein profiles in human liver, blood plasma, and white adipose tissue (WAT). In liver, we find that MASLD is associated with an increased abundance of proteins involved in immune response and extracellular matrix (ECM) and a decrease in proteins involved in metabolism. Cell type deconvolution of the proteome indicate liver endothelial and hepatic stellate cells as main source of the ECM rearrangements, and hepatocytes as the major contributor to the changes in liver metabolism. In the blood, profiles of several MASLD-associated proteins that correlate with their expression in WAT rather than liver yet could serve as suitable liver disease predictors in a multi-protein panel marker. Moreover, our proteomics-based logistic regression models consistently outperform existing methods for predicting MASLD and liver fibrosis from human blood samples.