Nonalcoholic steatohepatitis (NASH) is an aggressive liver disease threatening public health, however its natural history is poorly understood. Unlike ob/ob mice, Lep∆I14/∆I14 rats develop unique NASH phenotype with steatosis, lymphocyte infiltration and ballooning after postnatal week 16. Using Lep∆I14/∆I14 rats as NASH model, we studied the natural history of NASH progression by performing an integrated analysis of hepatic transcriptome from postnatal week 4 to 48. Leptin deficiency results

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... a robust increase in expression of genes encoding 9 rate-limiting enzymes in lipid metabolism such as ACC and FASN. However, genes in positive regulation of inflammatory response are highly expressed at week 16 and then remained the steady elevated expression till week 48. The high expression of cytokines and chemokines including CCL2, TNFɑ, IL6 and IL1β is correlated with the phosphorylation of several key molecules in pathways such as JNK and NF-κB. Meanwhile, we observed cell infiltration of MPO+ neutrophils, CD8+ T cells, CD68+ Kupffer cells and CCR2+ inflammatory monocyte-derived macrophages, together with macrophage polarization from M2 to M1. Importantly, Lep∆I14/∆I14 rats share more homologous genes with NASH patients than previously established mouse models and crab eating monkeys with spontaneous hepatic steatosis. Transcriptomic analysis showed that Lep∆I14/∆I14 many drug targets in clinical trials can be evaluated in Lep∆I14/∆I14 rats. Conclusion: We characterized Lep∆I14/∆I14 rats as a unique NASH model by performing a long-term (i.e., 4 to 48 postnatal weeks) integrated transcriptomic analysis. This work revealed the temporal dynamics of hepatic gene expression in lipid metabolism and inflammation, and shed light on understanding the natural history of NASH in human beings.