1. Pan-PPAR agonist lanifibranor improves portal hypertension and hepatic fibrosis in experimental advanced chronic liver disease
- Author
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Jaime Bosch, Claude Robert, Jean-Louis Junien, Guillaume Wettstein, Pierre Broqua, Jordi Gracia-Sancho, Anabel Fernández-Iglesias, Martí Ortega-Ribera, Peio Aristu-Zabalza, María Andrés-Rozas, and Zoe Boyer-Diaz
- Subjects
Liver Cirrhosis ,0301 basic medicine ,medicine.medical_specialty ,Cirrhosis ,Portal venous pressure ,Peroxisome Proliferator-Activated Receptors ,Anti-Inflammatory Agents ,Drug Evaluation, Preclinical ,610 Medicine & health ,Chronic liver disease ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Fibrosis ,Internal medicine ,Hypertension, Portal ,Ascites ,medicine ,Animals ,Humans ,Benzothiazoles ,Antihypertensive Agents ,Cells, Cultured ,Sulfonamides ,Hepatology ,business.industry ,medicine.disease ,Portal Pressure ,Rats ,Disease Models, Animal ,030104 developmental biology ,Liver ,Hepatic stellate cell ,Portal hypertension ,Vascular Resistance ,030211 gastroenterology & hepatology ,Antifibrotic Agents ,medicine.symptom ,Hepatic fibrosis ,business - Abstract
Background & aims In advanced chronic liver disease (ACLD), deregulated hepatic necroinflammatory processes play a key role in the development of liver microvascular dysfunction, fibrogenesis, and increased hepatic vascular tone, resulting in progression of ACLD and portal hypertension. Given the current lack of an effective treatment, we aimed to characterise the effects of the pan-peroxisome proliferator-activated receptor (pan-PPAR) agonist lanifibranor in 2 preclinical models of ACLD, as well as in liver cells from patients with ACLD. Methods Cirrhotic rats (thioacetamide or common bile duct ligation; TAA or cBDL) randomly received lanifibranor (100 mg/kg/day, po) or vehicle for 14 days (n = 12/group). PPAR expression, systemic and hepatic haemodynamics, presence of ascites, liver sinusoidal endothelial cell (LSEC) phenotype, hepatic stellate cell (HSC) activation, serum transaminases and albumin, hepatic macrophage infiltration, cytokine expression, and liver fibrosis were determined. Hepatic cells were isolated from the livers of patients with cirrhosis and their phenotype was evaluated after treatment with either lanifibranor or vehicle. Results TAA-cirrhotic rats receiving lanifibranor showed significantly lower portal pressure compared with vehicle-treated animals (-15%; p = 0.003) without decreasing portal blood flow, indicating improved hepatic vascular resistance. Moreover, lanifibranor-treated TAA-rats showed decreased ascites, improved LSEC and HSC phenotypes, ameliorated hepatic microvascular function, reduced hepatic inflammation, and significant fibrosis regression (-32%; p = 0.020). These findings were confirmed in the cBDL rat model as well as in human liver cells from patients with cirrhosis, which exhibited phenotypic improvement upon treatment with lanifibranor. Conclusions Lanifibranor ameliorates fibrosis and portal hypertension in preclinical models of decompensated cirrhosis. Promising results in human hepatic cells further support its clinical evaluation for the treatment of ACLD. Lay summary Advanced chronic liver disease (ACLD) constitutes a serious public health issue for which safe and effective treatments are lacking. This study shows that lanifibranor improves portal hypertension and liver fibrosis, 2 key elements of the pathophysiology of ACLD, in preclinical models of the disease. Evaluation of lanifibranor in liver cells from patients with ACLD further supports its beneficial effects.
- Published
- 2021