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Original Article

NAT10 deficiency in aging drives impaired liver regeneration by disrupting PARP10 in an ac4C-dependent manner

Qiang You1,2, Cuicui Xiao3, Haoqi Chen1,2, Gongming Zhang2, Feng Zhang4, Zhengqi Wu1,2, Yasong Liu1,2, Jiebin Zhang1,2, Haitian Chen1,2, Jiaqi Xiao1,2, Wenjie Chen4, Jia Yao1,2, Yingcai Zhang1,2,5, Hua Li1,2, Hui Li6, Yang Yang1,2, Rong Li1,2, Jun Zheng1,2
Published online: June 18, 2026
1Department of Hepatic Surgery and Liver Transplantation Center of the Third Affiliated Hospital of Sun Yat-sen University; Organ Transplantation Research Center of Guangdong Province, Guangdong Province Engineering Laboratory for Transplantation Medicine. Guangzhou 510630, China
2Guangdong Provincial Key Laboratory of Liver Disease Research, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
3Department of Anesthesiology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510630 China
4Biotherapy Center, the Third Affiliated Hospital of Sun Yat-sen University; Cell-gene Therapy Translational Medicine Research Center, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
5Department of Hepatobiliary Surgery, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830001, Xinjiang Uyghur Autonomous Region, China
6Department of Hepatobiliary Pancreatic Tumor Center, Chongqing Key Laboratory for the Mechanism and Intervention of Cancer Metastasis, Chongqing University Cancer Hospital, Chongqing, 400030, China
Corresponding author:  Hui Li,
Email: lih@cqu.edu.cn
Yang Yang,
Email: yysysu@163.com
Rong Li,
Email: lirong53@mail.sysu.edu.cn
Jun Zheng,
Email: zhengj96@mail.sysu.edu.cn

Qiang You, Cuicui Xiao, Haoqi Chen and Gongming Zhang contributed equally to this study as co-first authors.
Received: 14 March 2026   • Revised: 31 May 2026   • Accepted: 14 June 2026
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Background & aims
The age-related decline in liver regenerative capacity worsens outcomes for elderly patients with liver disease or undergoing liver surgery, and therapeutic options are limited. The RNA modification N4-acetylcytidine (ac4C), catalyzed by N-acetyltransferase 10 (Nat10), is implicated in regeneration; however, its role in the aged liver remains unknown.
Methods
We quantified Nat10/ac4C levels in human and murine livers across ages and correlated them with regenerative capacity. Function was assessed via hepatocyte-specific knockout, adeno-associated virus (AAV)-mediated gene manipulation, and pharmacological inhibition. Mechanisms were defined using integrated ac4C-specific immunoprecipitation sequencing (ac4C-seq), ribosome profiling (Ribo-seq), and RNA sequencing (RNA-seq).
Results
Hepatic Nat10 and ac4C levels decreased with age. Disruption of Nat10/ac4C impaired liver regeneration, whereas their augmentation enhanced it. Multi-omics integration linked ac4C to coordinated changes in mRNA abundance, stability, and translation. Mechanistically, Nat10 installed ac4C on Parp10 mRNA to enhance its stability and translational efficiency. Upregulated Parp10 inhibited GSK3β, thereby activating pro-regenerative β-catenin signaling. Furthermore, we identified the age-related decline in Nat10 was attributed to loss of its transcriptional driver, ATF3. Pharmacological induction of ATF3 restored Nat10 expression and rescued regeneration in aged liver.
Conclusion
Our study highlights the critical role of Nat10 in liver regeneration via mRNA ac4C-manner and identifies its age-related decline as a reversible impairment. Targeting this presents a promising therapeutic strategy for stimulating regeneration in the aged liver.

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NAT10 deficiency in aging drives impaired liver regeneration by disrupting PARP10 in an ac4C-dependent manner
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