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IF 7.5 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-10-01 DOI: 10.1016/S2589-5559(25)00289-7
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引用次数: 0
Copyright and information 版权及资料
IF 7.5 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-10-01 DOI: 10.1016/S2589-5559(25)00291-5
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引用次数: 0
Pre-emptive TIPS should be considered in high-risk patients with both acute variceal bleeding and severe alcohol-related hepatitis 急性静脉曲张出血和严重酒精相关性肝炎的高危患者应考虑预防性TIPS
IF 7.5 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-09-29 DOI: 10.1016/j.jhepr.2025.101611
Marika Rudler , Virginia Hernandez Gea , Hélène Larrue , Charlotte Bouzbib , Bogdan Procopet , Anna Baiges , Fanny Turon , Candido Villanueva , Agustin Albillos , Edilmar Alvarado Tapias , Lise Lott Gluud , Michael Praktiknjo , Joan Genesca , Meritxell Ventura-Cots , Ares Villagrasa , Susanna Rodrigues , Sarah Mouri , Álvaro Giráldez-Gallego , Helena Masnou Ridaura , Wim Laleman , Dominique Thabut

Background & Aims

Severe alcohol-related hepatitis (AH) and acute variceal bleeding (AVB) may occur simultaneously. The impact of a pre-emptive transjugular intrahepatic portosystemic shunt (pTIPS) in high-risk patients (patients with Child–Pugh (CP) B and active bleeding or CP C10–13 cirrhosis) with AVB and concomitant severe AH is unknown. The objective of the study was to compare the outcomes of severe AH in patients with high-risk AVB treated with pTIPS or endoscopic and drug treatment (Endo+drugs).

Methods

Patients were screened in four existing cohorts of patients with cirrhosis and AVB treated either with pTIPS or Endo+drugs. The inclusion criteria were AVB, high-risk patients, suspected severe AH (recent onset of jaundice, alcohol-related liver disease, absence of abstinence, model for end-stage liver disease score >20 and aspartate aminotransferase <500 UI/L). The primary endpoint was 42-day mortality, considering liver transplantation as a competing event. Secondary endpoints were rebleeding and further development of ascites or hepatic encephalopathy at 6 months.

Results

A total of 142 patients with AVB were included (pTIPS: n = 47, Endo+drugs: n = 95). Baseline characteristics (age 53, male sex 84%, model for end-stage liver disease score 23.4) were similar between the two groups. Overall, 56% had histologically proven AH. The 42-day mortality was 16% in the pTIPS group vs. 30% in the Endo+drugs group (p = 0.2). The cumulative incidence of rebleeding and ascites was significantly lower in the pTIPS group (2.8% vs. 24%, p = 0.026, and 6% vs. 52%, p <0.001, respectively), whereas hepatic encephalopathy occurrence was similar in the two groups (p = 0.2). Corticosteroid therapy was given in 55% and 46% of patients in the pTIPS and Endo+drugs groups, respectively (p = 0.3).

Conclusions

In severe AH, pTIPS is associated with better outcomes than Endo+drugs, and should not be contraindicated.

Impact and implications

Severe alcohol-related hepatitis and acute variceal bleeding may occur concomitantly, yet the role of pre-emptive transjugular intrahepatic portosystemic shunt (pTIPS) placement in this setting remains unclear. In this study, compared to standard of care, pTIPS treatment was associated with lower mortality, although this difference did not reach statistical significance, as well as a significantly reduced risk of rebleeding and recurrent ascites. These findings suggest that severe alcohol-related hepatitis should not be viewed as a contraindication to pTIPS placement when otherwise indicated, such as in patients with Child–Pugh B cirrhosis with a score greater than 7 and active bleeding, or Child–Pugh C10–13 disease.
背景和目的严重酒精相关性肝炎(AH)和急性静脉曲张出血(AVB)可能同时发生。预防性经颈静脉肝内门体分流术(pTIPS)对高危患者(Child-Pugh (CP) B和活动性出血或CP C10-13肝硬化)合并AVB和伴发严重AH的影响尚不清楚。该研究的目的是比较pTIPS或内镜和药物治疗(Endo+药物)治疗高危AVB患者严重AH的结局。方法在现有的四个肝硬化和AVB患者队列中筛选患者,这些患者接受pTIPS或Endo+药物治疗。纳入标准为AVB、高危患者、疑似重度AH(近期出现黄疸、酒精相关性肝病、无戒断、终末期肝病模型评分20分、天冬氨酸转氨酶500 UI/L)。考虑到肝移植是一个竞争项目,主要终点是42天死亡率。次要终点是6个月时再出血和腹水或肝性脑病的进一步发展。结果共纳入AVB患者142例(pTIPS: n = 47, Endo+药物:n = 95)。基线特征(53岁,男性84%,终末期肝病模型评分23.4)在两组之间相似。总的来说,56%的患者有组织学证实的AH。pTIPS组42天死亡率为16%,而Endo+药物组为30% (p = 0.2)。pTIPS组的再出血和腹水累积发生率显著降低(分别为2.8%对24%,p = 0.026, 6%对52%,p <0.001),而两组的肝性脑病发生率相似(p = 0.2)。pTIPS组和Endo+组分别有55%和46%的患者接受皮质类固醇治疗(p = 0.3)。结论pTIPS治疗严重AH疗效优于Endo+药物,不应禁用。影响和意义严重酒精相关性肝炎和急性静脉曲张出血可能同时发生,但在这种情况下,预防性经颈静脉肝内门静脉系统分流术(pTIPS)的作用尚不清楚。在本研究中,与标准治疗相比,pTIPS治疗与较低的死亡率相关,尽管这种差异没有达到统计学意义,并且显著降低了再出血和复发性腹水的风险。这些发现表明,当有其他适应症时,如Child-Pugh B肝硬化评分大于7且出血活动性或Child-Pugh C10-13疾病的患者,不应将严重酒精相关性肝炎视为pTIPS放置的禁忌症。
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引用次数: 0
Macrophage MRC2 deficiency mitigates HFD-induced MASLD by downregulating CD147-regulated TNF-α production 巨噬细胞MRC2缺陷通过下调cd147调控的TNF-α产生来减轻hfd诱导的MASLD
IF 7.5 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-09-24 DOI: 10.1016/j.jhepr.2025.101601
Hui-Ru Kuo , Kwei-Yan Liu , Hsin-Ying Clair Chiou , Yu-Fen Chung , Li-Ting Wang , Chih-Wen Wang , Shih-Hsien Hsu , Shau-Ku Huang , Ming-Hong Lin

Background & Aims

The mechanisms underlying metabolic dysfunction-associated steatotic liver disease (MASLD) remain incompletely understood, and macrophage-associated chronic inflammation has been suggested to play a role. We investigated the potential contribution of mannose receptor type C 2 (MRC2), a transmembrane glycoprotein, to MASLD development.

Methods

Wild-type (WT) and Mrc2-deficient mice were fed a high-fat diet (HFD) for 8 weeks. Mouse primary hepatocytes (MPHs) and bone marrow–derived macrophages (BMDMs) were stimulated with or without palmitic acid (PA) to assess the role of MRC2 in MASLD development.

Results

MRC2 levels were significantly elevated in patients with MASLD (n = 216, p <0.0001) and in the livers of HFD-fed WT mice (n = 6–8, p <0.01), correlating with disease severity. Mrc2-null mice exhibited reduced HFD-induced weight gain and steatosis compared with WT mice (n = 6–8). MRC2 was predominantly expressed in hepatic macrophages, and conditioned medium from WT BMDMs enhanced PA-induced steatosis in MPHs (n = 6, p <0.0001). This effect was absent when conditioned medium from Mrc2-deficient BMDMs was used or when TNF-α–neutralizing antibodies or TNF receptor antagonists were added. Macrophage-specific Mrc2 deficiency also reduced MASLD severity in HFD-fed mice (n = 6). Mechanistically, disruption of the MRC2–CD147 complex impaired CD147-mediated NF-κB signaling and reduced TNF-α release from BMDMs, thereby decreasing steatosis in co-cultured MPHs.

Conclusions

Macrophage MRC2 promotes HFD-induced hepatic steatosis via the MRC2–CD147 complex, revealing a novel mechanism contributing to MASLD progression.

Impact and implications

This study identifies the critical role of MRC2 in the development of high-fat diet-induced metabolic dysfunction-associated steatotic liver disease, providing a mechanistic understanding of its involvement in macrophage-mediated inflammation. Mrc2 deficiency alleviates hepatic inflammation and lipid accumulation by downregulating CD147-regulated TNF-α production in macrophages. The findings are particularly significant for researchers and clinicians focused on liver diseases, as they reveal a novel target – the macrophage MRC2-CD147 complex – for potential therapeutic intervention.
背景和目的代谢功能障碍相关脂肪变性肝病(MASLD)的机制尚不完全清楚,巨噬细胞相关的慢性炎症已被认为在其中发挥作用。我们研究了甘露糖受体2型(MRC2),一种跨膜糖蛋白,对MASLD发展的潜在贡献。方法野生型(WT)和mrc2缺陷型小鼠饲喂高脂饮食(HFD) 8周。用或不加棕榈酸(PA)刺激小鼠原代肝细胞(MPHs)和骨髓源性巨噬细胞(bmdm),以评估MRC2在MASLD发展中的作用。结果MASLD患者(n = 216, p <0.0001)和hfd喂养的WT小鼠肝脏中smrc2水平显著升高(n = 6-8, p <0.01),与疾病严重程度相关。与WT小鼠相比,mrc2缺失小鼠表现出较少的hfd诱导的体重增加和脂肪变性(n = 6-8)。MRC2主要在肝巨噬细胞中表达,WT bmdm的条件培养基增强了pa诱导的mph脂肪变性(n = 6, p <0.0001)。当使用mrc2缺陷bmdm的条件培养基或添加TNF-α -中和抗体或TNF受体拮抗剂时,这种效果不存在。巨噬细胞特异性Mrc2缺乏也降低了饲喂hfd小鼠的MASLD严重程度(n = 6)。从机制上讲,MRC2-CD147复合物的破坏破坏了cd147介导的NF-κB信号传导,减少了bmdm中TNF-α的释放,从而减少了共培养的mph的脂肪变性。结论巨噬细胞MRC2通过MRC2 - cd147复合物促进hfd诱导的肝脂肪变性,揭示了促进MASLD进展的新机制。影响和意义本研究确定了MRC2在高脂肪饮食诱导的代谢功能障碍相关脂肪变性肝病发展中的关键作用,为其参与巨噬细胞介导的炎症提供了机制理解。Mrc2缺乏通过下调巨噬细胞中cd147调控的TNF-α的产生来减轻肝脏炎症和脂质积累。这些发现对于关注肝脏疾病的研究人员和临床医生来说尤其重要,因为它们揭示了一个新的靶点——巨噬细胞MRC2-CD147复合物——用于潜在的治疗干预。
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引用次数: 0
High systemic inflammation response index and increased cardiovascular risk and mortality in MASLD: A prospective cohort study MASLD患者全身炎症反应指数高,心血管风险和死亡率增加:一项前瞻性队列研究
IF 7.5 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-09-24 DOI: 10.1016/j.jhepr.2025.101602
Haixiang Zheng , Kuangyi Wu , Hong Zheng , Guanlin Chen , Yulong Lan , Shuohua Chen , Gavino Casu , Leonardo Antonio Sechi , Shouling Wu , Gianpaolo Vidili , Youren Chen
<div><h3>Background & Aims</h3><div>The correlation between systemic inflammation response index (SIRI) and both cardiovascular disease (CVD, including myocardial infarction and total stroke) and mortality in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD) remains unclear. We examined this association in a large Chinese cohort.</div></div><div><h3>Methods</h3><div>A population of 24,340 patients with MASLD from the Kailuan study were observed over a median of 16.0 years. SIRI was calculated based on neutrophil, monocyte, and lymphocyte counts. Cox proportional hazards models were used to estimate hazard ratios (HRs) for CVD and mortality across SIRI quartiles. Net reclassification improvement assessed SIRI’s predictive value <em>vs.</em> high-sensitivity C-reactive protein and other indices. Mediation analysis assessed the roles of platelet count (PLT), Chinese visceral adiposity index and triglyceride-glucose index.</div></div><div><h3>Results</h3><div>During follow-up, 4,171 CVD events and 4,510 deaths occurred. Elevated SIRI was significantly linked to higher risks of CVD (HR for Q4 <em>vs.</em> Q1 1.21; 95% CI 1.10–1.31; <em>p <</em>0.001), including myocardial infarction (HR 1.22; 95% CI 1.01–1.48; <em>p</em> = 0.045), total stroke (HR 1.18; 95% CI 1.06–1.31; <em>p</em> = 0.003), and mortality (HR 1.34; 95% CI 1.24–1.46; <em>p <</em>0.001) in MASLD. Associations were stronger among women (HR 1.17; 95% CI 1.07–1.29; <em>p <</em>0.01) and physically inactive individuals (HR 1.09; 95% CI 1.05–1.13; <em>p <</em>0.01). SIRI improved outcome prediction over high-sensitivity C-reactive protein and other indices, with significant reclassification gains (5.84; 95% CI 2.57–9.12; <em>p <</em>0.001). Triglyceride-glucose index partially mediated these associations (5.3% for CVD, <em>p</em> = 0.006; 2.9% for mortality, <em>p</em> = 0.003), whereas PLT exhibited a slight inverse mediation effect on mortality (-3.3%, <em>p</em> = 0.032).</div></div><div><h3>Conclusions</h3><div>High SIRI independently correlates with increased risk of CVD and mortality in MASLD. These findings highlight the role of systemic inflammation and support SIRI as a potential biomarker for risk stratification in these individuals.</div></div><div><h3>Impact and implications</h3><div>This study provides important evidence linking systemic inflammation, as measured by the systemic inflammation response index, to increased cardiovascular disease and mortality in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD), a prevalent condition with rising global burden. The findings underscore the clinical relevance of inflammation markers in cardiovascular risk stratification, particularly for patients and healthcare providers managing MASLD. Physicians and policymakers could incorporate systemic inflammation response index into routine assessments to identify patients with MASLD at higher risk of cardiovascu
背景和目的在代谢功能障碍相关脂肪变性肝病(MASLD)患者中,全身性炎症反应指数(SIRI)与心血管疾病(CVD,包括心肌梗死和全卒中)和死亡率之间的相关性尚不清楚。我们在一个庞大的中国队列中检验了这种关联。方法对来自开滦研究的24340例MASLD患者进行了中位数为16.0年的观察。SIRI是根据中性粒细胞、单核细胞和淋巴细胞计数计算的。Cox比例风险模型用于估计SIRI四分位数中心血管疾病和死亡率的风险比(hr)。净重分类改进评估了SIRI与高灵敏度c反应蛋白和其他指标的预测价值。中介分析评估血小板计数(PLT),中国内脏脂肪指数和甘油三酯-葡萄糖指数的作用。结果随访期间共发生4171例CVD事件和4510例死亡。SIRI升高与心血管疾病的高风险显著相关(第4季度的风险比为1.21;95% CI 1.10-1.31; p <0.001),包括心肌梗死(HR 1.22; 95% CI 1.01-1.48; p = 0.045)、总卒中(HR 1.18; 95% CI 1.06-1.31; p = 0.003)和MASLD的死亡率(HR 1.34; 95% CI 1.24-1.46; p <0.001)。女性(HR 1.17; 95% CI 1.07-1.29; p <0.01)和不爱运动的个体(HR 1.09; 95% CI 1.05-1.13; p <0.01)的相关性更强。SIRI改善了对高灵敏度c反应蛋白和其他指标的预后预测,具有显著的再分类增益(5.84;95% CI 2.57-9.12; p <0.001)。甘油三酯-葡萄糖指数部分介导了这些关联(心血管疾病5.3%,p = 0.006;死亡率2.9%,p = 0.003),而PLT对死亡率表现出轻微的反向中介作用(-3.3%,p = 0.032)。结论高SIRI与MASLD患者CVD风险和死亡率增加独立相关。这些发现强调了全身性炎症的作用,并支持SIRI作为这些个体风险分层的潜在生物标志物。影响和意义本研究提供了重要的证据,表明全身性炎症反应指数与代谢功能障碍相关的脂肪变性肝病(MASLD)患者心血管疾病和死亡率增加有关,MASLD是一种全球负担不断增加的普遍疾病。研究结果强调了炎症标志物在心血管风险分层中的临床相关性,特别是对于管理MASLD的患者和医疗保健提供者。医生和决策者可以将全身性炎症反应指数纳入常规评估,以识别心血管事件高风险的MASLD患者,潜在地指导旨在减轻全身性炎症和代谢功能障碍的有针对性的干预措施。然而,由于主要是来自中国北方的以社区为基础的男性队列,在广泛的临床应用之前,有必要对不同人群进行进一步的研究来证实这些关联。临床试验编号chictr - tnc -11001489。
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引用次数: 0
Lenvatinib vs. sorafenib as second-line treatment post atezolizumab plus bevacizumab for hepatocellular carcinoma: The LEVIATHAN study Lenvatinib vs. sorafenib作为atezolizumab + bevacizumab治疗肝细胞癌后的二线治疗:LEVIATHAN研究
IF 7.5 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-09-23 DOI: 10.1016/j.jhepr.2025.101595
Pasquale Lombardi , Jung Sun Kim , Giulia F. Manfredi , Ciro Celsa , Claudia A.M. Fulgenzi , Antonio D’Alessio , Bernardo Stefanini , Niraj C. Doshi , Emily Warmington , Thomas U. Marron , Matthias Pinter , Bernhard Scheiner , Beodeul Kang , Ho Yeong Lim , Wei-Fan Hsu , Brooke Wietharn , Marianna Silletta , Alessandro Parisi , Chun-Yen Lin , Andrea Dalbeni , David J. Pinato
<div><h3>Background & Aims</h3><div>Atezolizumab plus bevacizumab (A+B) is a standard first-line systemic therapy for unresectable hepatocellular carcinoma (HCC). However, optimal sequencing strategies after A+B failure remain undefined.</div></div><div><h3>Methods</h3><div>LEVIATHAN is a multicentre, observational study evaluating efficacy and survival outcomes in patients who progressed on A+B and subsequently received either lenvatinib or sorafenib as second-line therapy. Of 1,210 patients treated with first-line A+B between May 2018 and August 2024, 230 eligible patients were included (lenvatinib, n = 125 [54.3%]; sorafenib, n = 105 [45.7%]). Propensity score matching was applied to adjust for baseline imbalances, incorporating independent predictors of overall survival (OS) and response to prior treatment.</div></div><div><h3>Results</h3><div>In the overall second-line cohort, lenvatinib was associated with superior median progression-free survival (5.5 <em>vs.</em> 2.6 months, hazard ratio [HR] 0.41, <em>p</em> <0.001) and median OS (11.9 <em>vs.</em> 7.4 months, HR 0.67, <em>p</em> = 0.018) compared to sorafenib. From the start of A+B, the A+B-lenvatinib sequence achieved a median OS of 22.4 months <em>vs.</em> 14.3 months with A+B-sorafenib (HR 0.54, <em>p</em> <0.001). These differences persisted in the propensity score-matched cohort (median OS: 19.6 <em>vs.</em> 13.9 months, HR 0.67, <em>p</em> = 0.024). Multivariate analysis identified treatment with lenvatinib as an independent predictor of improved OS alongside alpha-fetoprotein ≤400 ng/ml, neutrophil-to-lymphocyte ratio <3, and absence of portal vein thrombosis.</div></div><div><h3>Conclusions</h3><div>The LEVIATHAN study supports lenvatinib as a more effective second-line option than sorafenib following A+B in unresectable HCC, including in patients with primary resistance to immunotherapy. While limited by the observational study design, these findings highlight the importance of treatment sequencing to optimise outcomes in advanced HCC.</div></div><div><h3>Impact and implications</h3><div>Continuing active treatment after progression on frontline atezolizumab plus bevacizumab (A+B) can benefit patients with advanced hepatocellular carcinoma (HCC), but evidence to guide second-line therapy remains limited. The LEVIATHAN study addresses this gap by evaluating real-world outcomes in a large, prospective, multinational cohort treated with lenvatinib or sorafenib after A+B discontinuation. Our findings show that lenvatinib provides significantly longer progression-free and overall survival than sorafenib, even after adjusting for baseline imbalances with propensity scores. Lenvatinib also achieved higher disease control rates, including in patients with primary resistance to immunotherapy. These results challenge the assumption that all VEGFR-targeting TKIs are equivalent post-ICI and suggest lenvatinib may be superior to sorafenib following anti-VEGF–based immunotherapy
背景:AimsAtezolizumab + bevacizumab (A+B)是不可切除肝细胞癌(HCC)的标准一线全身治疗。然而,A+B失败后的最佳测序策略仍未确定。sleviathan是一项多中心观察性研究,评估a +B治疗进展并随后接受lenvatinib或sorafenib作为二线治疗的患者的疗效和生存结果。在2018年5月至2024年8月期间接受一线A+B治疗的1210例患者中,纳入230例符合条件的患者(lenvatinib, n = 125[54.3%];索拉非尼,n = 105[45.7%])。采用倾向评分匹配来调整基线失衡,结合总生存期(OS)和对既往治疗反应的独立预测因子。结果在整个二线队列中,lenvatinib与索拉非尼相比具有更高的中位无进展生存期(5.5个月vs 2.6个月,风险比[HR] 0.41, p <0.001)和中位OS(11.9个月vs 7.4个月,HR 0.67, p = 0.018)。从A+B开始,A+B-lenvatinib序列的中位OS为22.4个月,而A+B-索拉非尼组为14.3个月(HR 0.54, p <0.001)。这些差异在倾向评分匹配的队列中持续存在(中位生存期:19.6 vs 13.9个月,HR 0.67, p = 0.024)。多变量分析发现lenvatinib治疗与甲胎蛋白≤400ng /ml、中性粒细胞与淋巴细胞比率<;3和门静脉血栓的消失一起是改善OS的独立预测因素。利维坦研究支持lenvatinib作为不可切除HCC(包括对免疫治疗有原发性耐药的患者)a +B后更有效的二线选择。虽然受到观察性研究设计的限制,但这些发现强调了治疗排序对优化晚期HCC预后的重要性。影响和意义一线atezolizumab + bevacizumab (A+B)进展后继续积极治疗可使晚期肝细胞癌(HCC)患者受益,但指导二线治疗的证据仍然有限。LEVIATHAN研究通过评估a +B停药后lenvatinib或sorafenib治疗的大型前瞻性多国队列的实际结果,解决了这一差距。我们的研究结果表明,lenvatinib比sorafenib提供了更长的无进展生存期和总生存期,即使在调整了倾向评分的基线不平衡后也是如此。Lenvatinib也实现了更高的疾病控制率,包括对免疫治疗的原发性耐药患者。这些结果挑战了所有靶向vegfr的TKIs在ici后相同的假设,并表明lenvatinib可能优于基于抗vegf的免疫治疗的索拉非尼。虽然仍需要前瞻性随机试验,但这些真实世界的数据为临床医生提供了有价值的指导,并有助于改进晚期HCC的治疗顺序。
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引用次数: 0
Stage-dependent effects of systemic ASBT inhibition in a cholestasis-induced cholemic nephropathy mouse model 在胆汁淤积诱导的胆汁淤积肾病小鼠模型中,全身ASBT抑制的阶段依赖性作用
IF 7.5 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-09-23 DOI: 10.1016/j.jhepr.2025.101599
Ahmed Ghallab , Maiju Myllys , Daniela González , Adrian Friebel , Zaynab Hobloss , Reham Hassan , Hannah Schmidt , Qasim Siddiqui , Deng Zhipeng , Rama Hendawi , Brigitte Begher-Tibbe , Joerg Reinders , Katharina Derksen , Ute Hofmann , Julia C. Duda , Lucia Ameis , Kathrin Möllenhoff , Abdellatief Seddek , Noha Abdelmageed , Ellen Strängberg , Jan G. Hengstler

Background & Aims

Cholemic nephropathy (CN) is a severe complication of liver diseases associated with cholestasis and represents an unmet medical need. Recently, we identified the molecular mechanism of CN and showed that the systemic apical sodium-dependent bile acid transporter inhibitor (ASBTi) AS0369 prevented CN in mice. However, it is not clear if ASBTi is effective in a therapeutic rather than a preventive setting.

Methods

AS0369 was administered daily for 4 weeks to bile duct-ligated (BDL) mice at four CN stages: (1) early stage with proximal tubular epithelial cell (pTEC) death (BDL-day 3); (2) inflammation, leaky peritubular capillaries, and tubular dilatation (BDL-day 21); (3) fibrosis (BDL-day 42); and (4) advanced stage with glomerular cysts (BDL-day 63). Disease progression was evaluated by biochemical, histopathological, and RNA-sequencing analysis.

Results

ASBTi increased urinary excretion of bile acids (BAs) and reciprocally reduced BA concentrations in blood and renal tissue at all disease stages. Therapeutic efficacy was highest when ASBTi was given at early disease stages, e.g. urinary BA excretion was increased 9-fold (p <0.001) at the early stage compared to 4-fold (p = 0.021) at the late stage. ASBTi reduced the pTEC injury biomarker KIM-1, tissue damage, replacement proliferation, peritubular capillary damage and renal fibrosis. Additionally, late-stage disease features, such as glomerular cysts, were ameliorated (46% at the late stage, p = 0.005) by the ASBTi. RNA-sequencing revealed that ASBTi attenuated BDL-induced gene deregulation at all stages, with a larger effect size at early stages.

Conclusions

Early systemic ASBTi therapy, initiated at the onset of pTEC death, provides the greatest therapeutic benefit. Nonetheless, even at later stages, ASBTi can ameliorate features of advanced CN.

Impact and implications

This study demonstrates that systemic inhibition of the apical sodium-dependent bile acid transporter (ASBTi) alleviates cholemic nephropathy across disease stages in a bile duct ligation mouse model. The greatest benefit was achieved when treatment was initiated early, coinciding with proximal tubular epithelial cell death, but even advanced features such as glomerular cysts were partially reversed. These findings highlight ASBTi as a promising therapeutic strategy for cholemic nephropathy, addressing a major unmet need in cholestatic liver disease. By targeting bile acid accumulation and related injury pathways, ASBTi may improve renal outcomes and broaden treatment options in affected patients.
学术肾病(CN)是一种与胆汁淤积相关的肝脏疾病的严重并发症,代表着未满足的医疗需求。最近,我们确定了CN的分子机制,并发现系统性根尖钠依赖性胆汁酸转运抑制剂(ASBTi) AS0369对小鼠CN有预防作用。然而,目前尚不清楚ASBTi在治疗而非预防方面是否有效。方法将sas0369给予胆管结扎(BDL)小鼠,连续4周,分为4个CN阶段:(1)早期近端小管上皮细胞(pTEC)死亡(BDL- 3天);(2)炎症、小管周围毛细血管渗漏和小管扩张(bdl - 21天);(3)纤维化(bdl - 42天);(4)肾小球囊肿晚期(bdl - 63天)。通过生化、组织病理学和rna测序分析评估疾病进展。结果asbti增加了尿中胆汁酸(BAs)的排泄量,并降低了血液和肾组织中BA的浓度。在疾病早期给予ASBTi治疗效果最高,如尿BA排泄量在早期增加9倍(p <0.001),而在晚期增加4倍(p = 0.021)。ASBTi降低pTEC损伤生物标志物KIM-1、组织损伤、替代增生、小管周围毛细血管损伤和肾纤维化。此外,ASBTi改善了晚期疾病特征,如肾小球囊肿(晚期46%,p = 0.005)。rna测序结果显示,ASBTi在所有阶段都能减弱bdl诱导的基因失调,且在早期阶段效应更大。结论在pTEC死亡开始时进行早期全身ASBTi治疗可获得最大的治疗效果。尽管如此,即使在后期阶段,ASBTi也可以改善高级CN的特征。影响和意义本研究表明,在胆管结束术小鼠模型中,根尖钠依赖性胆汁酸转运体(ASBTi)的全身抑制可减轻疾病分期的胆碱性肾病。当早期开始治疗时,与近端小管上皮细胞死亡相吻合,可获得最大的益处,但即使是肾小球囊肿等晚期特征也可部分逆转。这些发现强调ASBTi作为一种有希望的治疗胆碱性肾病的策略,解决了胆汁淤积性肝病的主要未满足的需求。通过靶向胆汁酸积聚和相关损伤途径,ASBTi可以改善患者的肾脏预后,拓宽患者的治疗选择。
{"title":"Stage-dependent effects of systemic ASBT inhibition in a cholestasis-induced cholemic nephropathy mouse model","authors":"Ahmed Ghallab ,&nbsp;Maiju Myllys ,&nbsp;Daniela González ,&nbsp;Adrian Friebel ,&nbsp;Zaynab Hobloss ,&nbsp;Reham Hassan ,&nbsp;Hannah Schmidt ,&nbsp;Qasim Siddiqui ,&nbsp;Deng Zhipeng ,&nbsp;Rama Hendawi ,&nbsp;Brigitte Begher-Tibbe ,&nbsp;Joerg Reinders ,&nbsp;Katharina Derksen ,&nbsp;Ute Hofmann ,&nbsp;Julia C. Duda ,&nbsp;Lucia Ameis ,&nbsp;Kathrin Möllenhoff ,&nbsp;Abdellatief Seddek ,&nbsp;Noha Abdelmageed ,&nbsp;Ellen Strängberg ,&nbsp;Jan G. Hengstler","doi":"10.1016/j.jhepr.2025.101599","DOIUrl":"10.1016/j.jhepr.2025.101599","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Cholemic nephropathy (CN) is a severe complication of liver diseases associated with cholestasis and represents an unmet medical need. Recently, we identified the molecular mechanism of CN and showed that the systemic apical sodium-dependent bile acid transporter inhibitor (ASBTi) AS0369 prevented CN in mice. However, it is not clear if ASBTi is effective in a therapeutic rather than a preventive setting.</div></div><div><h3>Methods</h3><div>AS0369 was administered daily for 4 weeks to bile duct-ligated (BDL) mice at four CN stages: (1) early stage with proximal tubular epithelial cell (pTEC) death (BDL-day 3); (2) inflammation, leaky peritubular capillaries, and tubular dilatation (BDL-day 21); (3) fibrosis (BDL-day 42); and (4) advanced stage with glomerular cysts (BDL-day 63). Disease progression was evaluated by biochemical, histopathological, and RNA-sequencing analysis.</div></div><div><h3>Results</h3><div>ASBTi increased urinary excretion of bile acids (BAs) and reciprocally reduced BA concentrations in blood and renal tissue at all disease stages. Therapeutic efficacy was highest when ASBTi was given at early disease stages, <em>e.g</em>. urinary BA excretion was increased 9-fold (<em>p</em> &lt;0.001) at the early stage compared to 4-fold (<em>p</em> = 0.021) at the late stage. ASBTi reduced the pTEC injury biomarker KIM-1, tissue damage, replacement proliferation, peritubular capillary damage and renal fibrosis. Additionally, late-stage disease features, such as glomerular cysts, were ameliorated (46% at the late stage, <em>p</em> = 0.005) by the ASBTi. RNA-sequencing revealed that ASBTi attenuated BDL-induced gene deregulation at all stages, with a larger effect size at early stages.</div></div><div><h3>Conclusions</h3><div>Early systemic ASBTi therapy, initiated at the onset of pTEC death, provides the greatest therapeutic benefit. Nonetheless, even at later stages, ASBTi can ameliorate features of advanced CN.</div></div><div><h3>Impact and implications</h3><div>This study demonstrates that systemic inhibition of the apical sodium-dependent bile acid transporter (ASBTi) alleviates cholemic nephropathy across disease stages in a bile duct ligation mouse model. The greatest benefit was achieved when treatment was initiated early, coinciding with proximal tubular epithelial cell death, but even advanced features such as glomerular cysts were partially reversed. These findings highlight ASBTi as a promising therapeutic strategy for cholemic nephropathy, addressing a major unmet need in cholestatic liver disease. By targeting bile acid accumulation and related injury pathways, ASBTi may improve renal outcomes and broaden treatment options in affected patients.</div></div>","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 12","pages":"Article 101599"},"PeriodicalIF":7.5,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145517865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
FKBP9 enhances IGF2BP1-mediated m6A recognition to promote hepatocellular carcinoma progression FKBP9增强igf2bp1介导的m6A识别,促进肝细胞癌进展
IF 7.5 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-09-22 DOI: 10.1016/j.jhepr.2025.101584
Facai Yang , Anfeng Si , Cheng Chi , Weihu Ma , Yinmin Gu , Yongbo Pan , Jingzhan Zhu , Yigang He , Xuewu Tang , Qiushi Yu , Yanuo Chen , Tongfeng Liu , Shan Gao , Fangliang Xie , Zhengqing Lei , Hongping Xia , Zhangjun Cheng

Background & Aims

N6-methyladenosine (m6A) modification regulates mRNA stability and translation to promote cancer progression. FK506-binding protein 9 (FKBP9), a peptidyl-prolyl isomerase, is associated with carcinogenesis, but its role in m6A modification remains unclear. In this study we aimed to explore how FKBP9 regulates m6A modification during the development of hepatocellular carcinoma (HCC).

Methods

The expression of FKBP9 in HCC was profiled by reverse-transcription quantitative PCR, western blot, ELISA, and immunohistochemistry. Cell proliferation, migration, invasion, apoptosis, and mRNA stability were examined using CCK-8, colony formation, flow cytometry, and cycloheximide treatment. An orthotopic allograft tumor model was constructed for in vivo analysis. Immunoprecipitation, mass spectrometry, methylated RNA immunoprecipitation sequencing, and RNA sequencing were performed to elucidate underlying mechanisms.

Results

FKBP9 was significantly upregulated in both HCC tissues and serum (p <0.05) and correlated with unfavorable clinical outcomes in patients (p <0.05). Its overexpression enhanced HCC cell proliferation and metastasis, while its depletion triggered cell cycle arrest and apoptosis. Mechanistically, FKBP9 interacted with the KH3-4 domains of IGF2BP1 through its peptidyl-prolyl isomerase domain, thereby stabilizing the binding of IGF2BP1 to m6A-modified MYC and PDGFB. Clinical analysis further confirmed that FKBP9 expression was positively associated with the expression of MYC and PDGFB at both the mRNA and protein levels (p <0.05). Co-overexpression of FKBP9 with MYC or PDGFB was linked to a worse prognosis (p <0.05).

Conclusions

FKBP9 promotes HCC progression by facilitating IGF2BP1 recognition of m6A-modified transcripts, thereby stabilizing MYC and PDGFB. The FKBP9–IGF2BP1 axis represents a potential therapeutic target in HCC.

Impact and implications

This study highlights the critical role of FKBP9 in hepatocellular carcinoma progression by regulating IGF2BP1-mediated m6A RNA recognition, thereby enhancing the stability of key oncogenic transcripts such as MYC and PDGFB. These findings provide new insights into the molecular mechanisms driving hepatocellular carcinoma and identify potential therapeutic opportunities for patients with poor prognosis linked to high FKBP9 expression. The FKBP9–IGF2BP1 axis may serve as both a biomarker and a therapeutic target to guide the development of new treatment strategies. Further studies are warranted to validate these results in larger patient cohorts and to assess the clinical feasibility of targeting this pathway.
aimsn6 -甲基腺苷(m6A)修饰调节mRNA的稳定性和翻译,促进癌症进展。fk506结合蛋白9 (FKBP9)是一种肽基脯氨酸异构酶,与癌变有关,但其在m6A修饰中的作用尚不清楚。在这项研究中,我们旨在探讨FKBP9在肝细胞癌(HCC)发展过程中如何调节m6A修饰。方法采用反转录定量PCR、western blot、ELISA和免疫组化检测FKBP9在HCC中的表达。采用CCK-8、集落形成、流式细胞术和环己亚胺处理检测细胞增殖、迁移、侵袭、凋亡和mRNA稳定性。建立同种异体原位肿瘤模型进行体内分析。通过免疫沉淀、质谱、甲基化RNA免疫沉淀测序和RNA测序来阐明潜在的机制。结果fkbp9在HCC组织和血清中均显著上调(p <0.05),并与患者的不良临床结局相关(p <0.05)。它的过表达促进了HCC细胞的增殖和转移,而其缺失则引发细胞周期阻滞和细胞凋亡。机制上,FKBP9通过其肽基脯氨酸异构酶结构域与IGF2BP1的KH3-4结构域相互作用,从而稳定IGF2BP1与m6a修饰的MYC和PDGFB的结合。临床分析进一步证实FKBP9的表达在mRNA和蛋白水平上与MYC和PDGFB的表达呈正相关(p <0.05)。FKBP9与MYC或PDGFB共同过表达与较差的预后相关(p <0.05)。结论sfkbp9通过促进IGF2BP1对m6a修饰转录物的识别,从而稳定MYC和PDGFB,从而促进HCC进展。FKBP9-IGF2BP1轴代表HCC的潜在治疗靶点。影响和意义本研究强调了FKBP9通过调节igf2bp1介导的m6A RNA识别,从而增强关键致癌转录物如MYC和PDGFB的稳定性,在肝细胞癌进展中的关键作用。这些发现为研究驱动肝细胞癌的分子机制提供了新的见解,并为与FKBP9高表达相关的预后不良患者确定了潜在的治疗机会。FKBP9-IGF2BP1轴可以作为生物标志物和治疗靶点来指导新的治疗策略的发展。进一步的研究需要在更大的患者队列中验证这些结果,并评估以该途径为靶点的临床可行性。
{"title":"FKBP9 enhances IGF2BP1-mediated m6A recognition to promote hepatocellular carcinoma progression","authors":"Facai Yang ,&nbsp;Anfeng Si ,&nbsp;Cheng Chi ,&nbsp;Weihu Ma ,&nbsp;Yinmin Gu ,&nbsp;Yongbo Pan ,&nbsp;Jingzhan Zhu ,&nbsp;Yigang He ,&nbsp;Xuewu Tang ,&nbsp;Qiushi Yu ,&nbsp;Yanuo Chen ,&nbsp;Tongfeng Liu ,&nbsp;Shan Gao ,&nbsp;Fangliang Xie ,&nbsp;Zhengqing Lei ,&nbsp;Hongping Xia ,&nbsp;Zhangjun Cheng","doi":"10.1016/j.jhepr.2025.101584","DOIUrl":"10.1016/j.jhepr.2025.101584","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>N<sup>6</sup>-methyladenosine (m<sup>6</sup>A) modification regulates mRNA stability and translation to promote cancer progression. FK506-binding protein 9 (FKBP9), a peptidyl-prolyl isomerase, is associated with carcinogenesis, but its role in m<sup>6</sup>A modification remains unclear. In this study we aimed to explore how FKBP9 regulates m<sup>6</sup>A modification during the development of hepatocellular carcinoma (HCC).</div></div><div><h3>Methods</h3><div>The expression of FKBP9 in HCC was profiled by reverse-transcription quantitative PCR, western blot, ELISA, and immunohistochemistry. Cell proliferation, migration, invasion, apoptosis, and mRNA stability were examined using CCK-8, colony formation, flow cytometry, and cycloheximide treatment. An orthotopic allograft tumor model was constructed for <em>in vivo</em> analysis. Immunoprecipitation, mass spectrometry, methylated RNA immunoprecipitation sequencing, and RNA sequencing were performed to elucidate underlying mechanisms.</div></div><div><h3>Results</h3><div>FKBP9 was significantly upregulated in both HCC tissues and serum (<em>p</em> &lt;0.05) and correlated with unfavorable clinical outcomes in patients (<em>p</em> &lt;0.05). Its overexpression enhanced HCC cell proliferation and metastasis, while its depletion triggered cell cycle arrest and apoptosis. Mechanistically, FKBP9 interacted with the KH3-4 domains of IGF2BP1 through its peptidyl-prolyl isomerase domain, thereby stabilizing the binding of IGF2BP1 to m<sup>6</sup>A-modified <em>MYC</em> and <em>PDGFB</em>. Clinical analysis further confirmed that FKBP9 expression was positively associated with the expression of MYC and PDGFB at both the mRNA and protein levels (<em>p</em> &lt;0.05). Co-overexpression of FKBP9 with MYC or PDGFB was linked to a worse prognosis (<em>p</em> &lt;0.05).</div></div><div><h3>Conclusions</h3><div>FKBP9 promotes HCC progression by facilitating IGF2BP1 recognition of m6A-modified transcripts, thereby stabilizing MYC and PDGFB. The FKBP9–IGF2BP1 axis represents a potential therapeutic target in HCC.</div></div><div><h3>Impact and implications</h3><div>This study highlights the critical role of FKBP9 in hepatocellular carcinoma progression by regulating IGF2BP1-mediated m6A RNA recognition, thereby enhancing the stability of key oncogenic transcripts such as <em>MYC</em> and <em>PDGFB</em>. These findings provide new insights into the molecular mechanisms driving hepatocellular carcinoma and identify potential therapeutic opportunities for patients with poor prognosis linked to high FKBP9 expression. The FKBP9–IGF2BP1 axis may serve as both a biomarker and a therapeutic target to guide the development of new treatment strategies. Further studies are warranted to validate these results in larger patient cohorts and to assess the clinical feasibility of targeting this pathway.</div></div>","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 12","pages":"Article 101584"},"PeriodicalIF":7.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145464822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A retrospective evaluation of preemptive liver transplantation for bile duct dysplasia in primary sclerosing cholangitis: Balancing risks and benefits 回顾性评价原发性硬化性胆管炎患者胆管发育不良的预防性肝移植:平衡风险和收益
IF 7.5 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-09-20 DOI: 10.1016/j.jhepr.2025.101598
Sigurd Breder , Christina Villard , Emma Eide , Benny Wang , Lise Katrine Engesæter , Henrik Mikael Reims , Johannes Roksund Hov , Espen Melum , Lars Aabakken , Pål Dag Line , Jon Lømo , Krzyztof Grzyb , Kristine Wiencke , Annika Bergquist , Trine Folseraas

Background & Aims

Liver transplantation (LT) to prevent cholangiocarcinoma (CCA) in individuals with primary sclerosing cholangitis (PSC) and bile duct dysplasia was introduced in Norway and Sweden in the early 2000s. We aimed to evaluate this practice to potentially improve future selection of candidates for LT.

Methods

We conducted a retrospective study of 512 adults with PSC who underwent first-time LT between 2000–2021 at Oslo and Karolinska University Hospitals. Pre-LT findings in bile duct brush cytology and/or biopsy of low-grade dysplasia (LGD) and high-grade dysplasia (HGD) were compared with histological findings in the explanted livers and survival rates were assessed.

Results

Bile duct dysplasia, low-grade (LGD) or high-grade (HGD), was the primary LT indication in 17% (88/512). Among individuals transplanted for LGD, only 10% (3/29) had HGD or CCA in the explant, compared to 48% (28/59) in the HGD group. No neoplasia was found in 42% (12/29) of LGD and 24% (14/59) of HGD cases, meaning nearly one-third of patients transplanted for suspected bile duct dysplasia had no histological evidence of neoplasia in the explant. Five-year post-transplant survival according to the explant histology was 95% for no neoplasia, 89% for LGD, 85% for HGD, decreasing to 33% in those with CCA in the explant.

Conclusions

While favorable survival in confirmed dysplasia supports the role of preemptive LT, the absence of neoplasia in a substantial proportion of explants, particularly in suspected LGD, calls for a cautious, individualized approach. LT appears more clearly justified in accurately diagnosed HGD, given its strong association with early malignancy and the poor prognosis of advanced CCA.

Impact and implications

Individuals with primary sclerosing cholangitis (PSC) are at increased risk of developing bile duct cancer. In precancerous stages (bile duct dysplasia), liver transplantation (LT) may prevent progression to advanced, incurable cancer. In our evaluation of 512 patients with PSC who underwent LT, we found that the low diagnostic accuracy and unpredictable detection of mild dysplasia support a cautious, individualized approach to LT in precancerous stages of PSC, while more advanced dysplasia remains a valid indication for LT.
背景:21世纪初,挪威和瑞典在原发性硬化性胆管炎(PSC)和胆管发育不良患者中引入了银条移植(LT)来预防胆管癌(CCA)。我们的目的是评估这种做法,以潜在地改善未来LT候选人的选择。方法我们对2000年至2021年期间在奥斯陆和卡罗林斯卡大学医院接受首次LT治疗的512名PSC成人患者进行了回顾性研究。将肝移植前胆管刷细胞学和/或活检的低级别不典型增生(LGD)和高级别不典型增生(HGD)结果与移植肝脏的组织学结果进行比较,并评估生存率。结果17%(88/512)患者的主要肝移植指状是胆管发育不良,低级别(LGD)或高级别(HGD)。在移植LGD的个体中,只有10%(3/29)的外植体有HGD或CCA,而HGD组有48%(28/59)。42%(12/29)的LGD和24%(14/59)的HGD未发现瘤变,这意味着近三分之一因疑似胆管发育不良而移植的患者在移植体中未发现瘤变的组织学证据。根据外植体组织学,无肿瘤的移植后5年生存率为95%,LGD为89%,HGD为85%,外植体中有CCA的移植后5年生存率降至33%。结论:虽然在确诊的非典型增生患者中,良好的生存率支持了抢先性肝移植的作用,但在相当大比例的外植体中,特别是在疑似LGD的外植体中,没有肿瘤的存在,需要谨慎、个性化的治疗方法。考虑到肝移植与早期恶性肿瘤和晚期CCA的不良预后密切相关,肝移植在准确诊断的HGD中显得更为合理。影响和意义原发性硬化性胆管炎(PSC)患者发生胆管癌的风险增加。在癌前阶段(胆管发育不良),肝移植(LT)可以防止进展到晚期,无法治愈的癌症。在我们对512例接受肝移植的PSC患者的评估中,我们发现诊断准确性低和轻度不典型增生的不可预测的检测支持对PSC癌前阶段的肝移植采取谨慎、个性化的方法,而更晚期的不典型增生仍然是肝移植的有效适应症。
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引用次数: 0
Development of a CRE/CREB-driven HBx responsive HBV cell culture reporter system for antiviral drug evaluation 用于抗病毒药物评估的CRE/ creb驱动HBx应答性HBV细胞培养报告系统的开发
IF 7.5 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Pub Date : 2025-09-18 DOI: 10.1016/j.jhepr.2025.101596
Muhammad Atif Zahoor , Nahla FadlElMawla , Adrian Kuipery , Joshua B. Feld , Avisha Chowdhury , Alexander I. Mosa , Adam J. Gehring , Jordan J. Feld

Background & Aims

Chronic HBV infection is a leading cause of liver disease and cancer. Current therapies fail to eliminate covalently closed circular DNA (cccDNA), underscoring the need for novel strategies. We aimed to develop a quantitative cell-based reporter system that detects HBx expression during HBV infection and is suitable for screening compounds with anti-HBV activity.

Methods

We generated an HBx-responsive cell line stably expressing nano-luciferase (nLuc) under the control of a viral cAMP-response element (vCRE) derived from the human T-cell leukemia virus-1 core promoter. The system was used to evaluate various drug inhibitors in HBV-infected cells.

Results

The vCRE-nLuc system was confirmed to be responsive to HBx using pHBV1.3-wild-type, pHBV1.3-null-X and pMyc-HBx constructs (p <0.0001). HBV infection with both culture-derived and patient-derived clinical isolates (genotypes A-E) significantly increased luciferase activity (p <0.0001). Treatment with HBx inhibitors (siRNA, specific HBx inhibitors), as well as IFNα reduced luciferase production (p <0.0001). In contrast, antivirals that do not interfere with protein production (tenofovir), or viral entry (bulevirtide) showed no effect (p <0.05), underscoring the specificity of the system for identifying compounds that inhibit protein production and/or HBx function. Finally, HepG2.2.15 cells carrying HBV and transduced with vCRE-nLuc confirmed the system’s suitability for monitoring HBV infection.

Conclusions

We established a vCRE-nLuc-driven HBx-responsive cell line for quantitative monitoring of HBV infection and evaluation of antiviral drugs. This system holds potential for identifying new anti-HBV agents and advancing our understanding of HBV replication.

Impact and implications

The HBx-responsive vCRE-nLuc reporter system provides a sensitive and scalable platform to monitor HBV infection and evaluate antiviral compounds targeting HBx function. Its ability to detect HBx activity from both laboratory and clinical HBV isolates underscore its translational relevance. By enabling selective screening of HBx-targeting agents, this system may advance efforts to silence covalently closed circular DNA and accelerate the development of curative therapies for chronic hepatitis B.
背景:慢性HBV感染是肝脏疾病和癌症的主要原因。目前的治疗方法不能消除共价闭合环状DNA (cccDNA),强调需要新的策略。我们的目标是开发一种基于细胞的定量报告系统,用于检测HBV感染期间HBx的表达,并适用于筛选具有抗HBV活性的化合物。方法在来源于人t细胞白血病病毒-1核心启动子的病毒cAMP-response元件(vCRE)的控制下,构建稳定表达纳米荧光素酶(nLuc)的hbx应答细胞系。该系统用于评估hbv感染细胞中的各种药物抑制剂。结果通过pHBV1.3-wild-type、pHBV1.3-null-X和pMyc-HBx构建体证实vCRE-nLuc系统对HBx有应答(p <0.0001)。培养源性和患者源性临床分离株(基因型A-E)感染HBV均显著增加荧光素酶活性(p <0.0001)。用HBx抑制剂(siRNA,特异性HBx抑制剂)和IFNα治疗可减少荧光素酶的产生(p <0.0001)。相反,不干扰蛋白质产生(替诺福韦)或病毒进入(布来韦肽)的抗病毒药物没有效果(p <0.05),强调了该系统识别抑制蛋白质产生和/或HBx功能的化合物的特异性。最后,携带HBV并经vCRE-nLuc转导的HepG2.2.15细胞证实了该系统监测HBV感染的适用性。结论我们建立了vcre - nluc驱动的hbx反应细胞系,用于HBV感染的定量监测和抗病毒药物的评价。该系统具有识别新的抗HBV药物和推进我们对HBV复制的理解的潜力。影响和意义HBx反应性vCRE-nLuc报告系统为监测HBV感染和评估靶向HBx功能的抗病毒化合物提供了一个敏感和可扩展的平台。其检测实验室和临床HBV分离株HBx活性的能力强调了其翻译相关性。通过选择性筛选hbx靶向药物,该系统可能会促进共价闭合环状DNA的沉默,并加速慢性乙型肝炎治疗方法的发展。
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