Mitochondrial dysfunction underlies monocyte immune deficiency in patients with severe alcohol-related hepatitis

Abstract

Severe alcohol-related hepatitis (sAH) is a life-threatening form of alcohol-related liver disease (ARLD) associated with a significant short-term mortality. Opportunistic infections due to impaired immune function are a major cause of patient mortality. Mitochondrial dysfunction within the liver is a well-recognised feature of ARLD and sAH. However, whether these hepatic mitochondrial defects extend to the immune system of sAH patients, underlying their immune dysfunction, remains unclear. Here, we demonstrate that sAH monocytes exhibit an increased content of inefficient, dysfunctional mitochondria. These changes were underpinned by abnormal mitochondrial cristae ultrastructure, which were associated with depletion of cristae structural proteins and alterations in cardiolipin profiles. Overall, our study uncovers novel structural and functional mitochondrial defects, which likely contribute to impaired monocyte immune function in sAH.