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Nonalcoholic fatty liver disease, recently renamed metabolic dysfunction- associated steatotic liver disease (MASLD), is a progressive metabolic disorder that begins with aberrant triglyceride accumulation in the liver and can lead to cirrhosis and cancer. A common variant in the gene PNPLA3, encoding the protein PNPLA3- I148M, is the strongest known genetic risk factor for MASLD. Despite its discovery 20 y ago, the function of PNPLA3, and now the role of PNPLA3- I148M, remain unclear. In this study, we sought to dissect the biogenesis of PNPLA3 and PNPLA3- I148M and characterize changes induced by endogenous expression of the disease- causing variant. Contrary to bioinformatic predictions and prior studies with overexpressed proteins, we demonstrate here that PNPLA3 and PNPLA3- I148M are not endoplasmic reticulum- resident transmembrane proteins. To identify their intracellular associations, we generated a paired set of isogenic human hepatoma cells expressing PNPLA3 and PNPLA3- I148M at endogenous levels. Both proteins were enriched in lipid droplet, Golgi, and endosomal fractions. Purified PNPLA3 and PNPLA3- I148M proteins associated with phosphoinositides commonly found in these compartments. Despite a similar fractionation pattern as the wild- type variant, PNPLA3- I148M induced morphological changes in the Golgi apparatus, including increased lipid droplet--Golgi contact sites, which were also observed in I148M- expressing primary human patient hepatocytes. In addition to lipid droplet accumulation, PNPLA3- I148M expression caused significant proteomic and transcriptomic changes that resembled all stages of liver disease. Cumulatively, we validate an endogenous human cellular system for investigating PNPLA3- I148M biology and identify the Golgi apparatus as a central hub of PNPLA3- I148M- driven cellular change. [ABSTRACT FROM AUTHOR]

Glycerophospholipids are synthesized primarily in the cytosolic leaflet of the endoplasmic reticulum (ER) membrane and must be equilibrated between bilayer leaflets to allow the ER and membranes derived from it to grow. Lipid equilibration is facilitated by integral membrane proteins called "scramblases." These proteins feature a hydrophilic groove allowing the polar heads of lipids to traverse the hydrophobic membrane interior, similar to a credit card moving through a reader. Nevertheless, despite their fundamental role in membrane expansion and dynamics, the identity of most scramblases has remained elusive. Here, combining biochemical reconstitution and molecular dynamics simulations, we show that lipid scrambling is a general feature of protein insertases, integral membrane proteins which insert polypeptide chains into membranes of the ER and organelles disconnected from vesicle trafficking. Our data indicate that lipid scrambling occurs in the same hydrophilic channel through which protein insertion takes place and that scrambling is abolished in the presence of nascent polypeptide chains. We propose that protein insertases could have a so-far-overlooked role in membrane dynamics as scramblases. [ABSTRACT FROM AUTHOR]