Project Summary Chronic alcohol abuse has been linked to abnormal epigenetic modifications that affect the progression of alcoholic liver disease (ALD) by influencing factors in controlling cell death in hepatocytes. One such factor is 5-hydroxymethylcytosine (5hmC), but there is currently little information as to how chronic alcohol consumption affects 5hmC's regulation of cell death. Understanding how alcohol impacts 5hmC formation and consequently cell death pathways will potentially yield therapeutic approaches towards ALD. In our preliminary studies, we found that 5hmC expression is down-regulated in the livers of rats and mice fed with an ethanol diet as well as in human ALD tissues. We further examined the expression levels of enzymes involved in the generation of 5hmC, which include methylcytosine dioxygenase TET1, TET2, and TET3 in ALD samples. It was found that TET1 is significantly down-regulated in human and rodent ALD samples. We determined that using shRNA- TET1 to knockdown TET1 in human hepatocytes significantly suppressed 5hmC formation and promoted cell death as well as the pro-apoptotic gene, HRK. Intriguingly, the treatment of the DNA methylation inhibitor, 5- Azacytidine, could replace the impact of TET1 knockdown on hepatocyte cell death, further suggesting the importance of DNA methylation in TET1-mediated hepatocyte cell death. We then analyzed how TET1 down- regulation is involved in ALD progression by using TET1 knockout mice. It was found that knockout of TET1 substantially elicited liver fibrosis, which is consequently the outcome of wound-healing in chronic liver damage. Thus, our central hypothesis is that ethanol exposure increases hepatocyte cell death to promote ALD progression by suppressing TET1-mediated 5hmC epigenetic changes. Our long-term objective is to clarify the underlying mechanisms by which TET1 modulates ALD progression, and determine if TET1 is a potential therapeutic target in ALD. Two specific aims propose to evaluate our hypothesis. In aim 1, we will examine how TET1 modulates cell death pathways in ALD progression. We will investigate the enzymatic function of TET1 in regulating cell death pathways by using TET1 catalytic domain, full length TET1, TET1 catalytic domain dead mutation, and TET1 specific inhibitor. In aim 2, we will examine the role of TET1 in ALD progression. We will evaluate the impact of TET1 down-regulation on hepatocyte cell death in wild-type (WT) and TET1 knockout (KO) mice challenged with an alcoholic liquid diet. To further determine the hepatic specific TET1 role in ALD progression, we will generate liver specific TET1 knockout mice by using albumin promoter driven Cre mouse and floxed TET1 mouse. The results will significantly advance our knowledge of the mechanisms by which TET1 modulates hepatocyte cell death and improve our understanding of pathophysiological mechanisms underlying ALD progression. We also anticipate that it will have a broad impact on the understanding of TET1 expression and its relationship to hepatocyte function in general.