Cholangiocytes act as facultative liver stem cells during impaired hepatocyte regeneration

Two independent systems impairing hepatocyte proliferation during liver injury cause physiologically significant levels of functional hepatocyte regeneration from biliary cells. Liver injury triggers regeneration through proliferation of hepatocytes to compensate for the loss of cells. However, in humans, this process is impaired in chronic liver diseases and it has been difficult to reproduce this impairment in mouse models of liver injury. Stuart Forbes and colleagues have used two systems to impair hepatocyte proliferation, via impairment of β-integrin or overexpression of the cell cycle inhibitor p21. They observe that, following injury under these conditions, epithelial bile duct cells are able to adopt hepatic fate and regenerate up to 25% of functional hepatocytes. After liver injury, regeneration occurs through self-replication of hepatocytes. In severe liver injury, hepatocyte proliferation is impaired—a feature of human chronic liver disease1,2. It is unclear whether other liver cell types can regenerate hepatocytes3,4,5. Here we use two independent systems to impair hepatocyte proliferation during liver injury to evaluate the contribution of non-hepatocytes to parenchymal regeneration. First, loss of β1-integrin in hepatocytes with liver injury triggered a ductular reaction of cholangiocyte origin, with approximately 25% of hepatocytes being derived from a non-hepatocyte origin. Second, cholangiocytes were lineage traced with concurrent inhibition of hepatocyte proliferation by β1-integrin knockdown or p21 overexpression, resulting in the significant emergence of cholangiocyte-derived hepatocytes. We describe a model of combined liver injury and inhibition of hepatocyte proliferation that causes physiologically significant levels of regeneration of functional hepatocytes from biliary cells.