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Nalkurthi C, Schroder WA, Melino M, Irvine KM, Nyuydzefe M, Chen W, Liu J, Teng MWL, Hill GR, Bertolino P, Blazar BR, Miller GC, Clouston AD, Zanin-Zhorov A, MacDonald KPA. ROCK2 inhibition attenuates profibrogenic immune cell function to reverse thioacetamide-induced liver fibrosis. JHEP Rep 2021; 4:100386. [PMID: 34917911 PMCID: PMC8645924 DOI: 10.1016/j.jhepr.2021.100386] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 09/27/2021] [Accepted: 09/29/2021] [Indexed: 12/12/2022]
Abstract
Background & Aims Fibrosis, the primary cause of morbidity in chronic liver disease, is induced by pro-inflammatory cytokines, immune cell infiltrates, and tissue resident cells that drive excessive myofibroblast activation, collagen production, and tissue scarring. Rho-associated kinase 2 (ROCK2) regulates key pro-fibrotic pathways involved in both inflammatory reactions and altered extracellular matrix remodelling, implicating this pathway as a potential therapeutic target. Methods We used the thioacetamide-induced liver fibrosis model to examine the efficacy of administration of the selective ROCK2 inhibitor KD025 to prevent or treat liver fibrosis and its impact on immune composition and function. Results Prophylactic and therapeutic administration of KD025 effectively attenuated thioacetamide-induced liver fibrosis and promoted fibrotic regression. KD025 treatment inhibited liver macrophage tumour necrosis factor production and disrupted the macrophage niche within fibrotic septae. ROCK2 targeting in vitro directly regulated macrophage function through disruption of signal transducer and activator of transcription 3 (STAT3)/cofilin signalling pathways leading to the inhibition of pro-inflammatory cytokine production and macrophage migration. In vivo, KDO25 administration significantly reduced STAT3 phosphorylation and cofilin levels in the liver. Additionally, livers exhibited robust downregulation of immune cell infiltrates and diminished levels of retinoic acid receptor-related orphan receptor gamma (RORγt) and B-cell lymphoma 6 (Bcl6) transcription factors that correlated with a significant reduction in liver IL-17, splenic germinal centre numbers and serum IgG. Conclusions As IL-17 and IgG–Fc binding promote pathogenic macrophage differentiation, together our data demonstrate that ROCK2 inhibition prevents and reverses liver fibrosis through direct and indirect effects on macrophage function and highlight the therapeutic potential of ROCK2 inhibition in liver fibrosis. Lay summary By using a clinic-ready small-molecule inhibitor, we demonstrate that selective ROCK2 inhibition prevents and reverses hepatic fibrosis through its pleiotropic effects on pro-inflammatory immune cell function. We show that ROCK2 mediates increased IL-17 production, antibody production, and macrophage dysregulation, which together drive fibrogenesis in a model of chemical-induced liver fibrosis. Therefore, in this study, we not only highlight the therapeutic potential of ROCK2 targeting in chronic liver disease but also provide previously undocumented insights into our understanding of cellular and molecular pathways driving the liver fibrosis pathology. ROCK2 inhibition with the small-molecule inhibitor KD025 prevents and reverses hepatoxin-induced liver fibrosis. ROCK2 inhibition attenuates profibrogenic immune function. KD025 exerts direct effects on liver macrophages resulting in decreased TNF secretion and impeded migration. KD025 administration attenuates T cell IL-17 production and B-cell IgG production, which indirectly contributes to downregulation of profibrogenic macrophage function.
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Key Words
- ALT, alanine aminotransferase
- AST, aspartate aminotransferase
- B cells
- BMDM, bone marrow-derived macrophages
- Bcl6, B-cell lymphoma 6
- CLD, chronic liver disease
- Col1a2, collagen type α1
- DR, ductular reaction
- ECM, extracellular matrix
- GC, germinal centre
- HCC, hepatocellular carcinoma
- HSC, hepatic stellate cell
- IHC, immunohistochemical
- IL-17
- Inflammation
- LPS, lipopolysaccharide
- Liver fibrosis
- MMP, matrix metalloproteinase
- Macrophages
- NASH, non-alcoholic steatohepatitis
- RAR, retinoic acid receptor
- ROCK, Rho-associated coiled-coil forming protein kinases
- ROCK2
- ROCK2, Rho-associated kinase 2
- RORγt, RAR-related orphan receptor gamma
- SR, Sirius red
- STAT3, signal transducer and activator of transcription 3
- TAA, thioacetamide
- TGF-β, transforming growth factor-beta
- TNF, tumour necrosis factor
- Tfh, T follicular helper
- Th17, T helper 17
- Therapy
- cGVHD, chronic graft-vs-host disease
- pCofilin, phosphorylated cofilin
- pMac, peritoneal macrophages
- pSTAT3, phosphorylated signal transducer and activator of transcription
- qRT-PCR, quantitative real-time PCR
- α-SMA, alpha smooth muscle actin
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Affiliation(s)
- Christina Nalkurthi
- QIMR Berghofer Medical Research Institute, Brisbane, Australia.,The University of Queensland, Brisbane, QLD, Australia
| | | | - Michelle Melino
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Katharine M Irvine
- Mater Research, Translational Research Institute, University of Queensland, Brisbane, Australia
| | | | - Wei Chen
- Kadmon Corporation LLC, New York, NY, USA
| | - Jing Liu
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | | | - Geoffrey R Hill
- Clinical Research Division, Fred Hutchinson Cancer Research Centre, Seattle, WA, USA
| | | | - Bruce R Blazar
- Masonic Cancer Center and Division of Blood and Marrow Transplantation, Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
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