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Kornyeyev D, Song Z, Eng S, Soulette C, Ramirez R, Tang J, Yue Q, Subramanian R, Zaboli S, Moon C, Tam J, Brodbeck J, Aggarwal A, Diehl L, Fletcher SP, Hyrina A, Holdorf MM, Burdette D. Selective depletion of HBV-infected hepatocytes by class A capsid assembly modulators requires high levels of intrahepatic HBV core protein. Antimicrob Agents Chemother 2024:e0042024. [PMID: 38780261 DOI: 10.1128/aac.00420-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 05/02/2024] [Indexed: 05/25/2024] Open
Abstract
Capsid assembly mediated by hepatitis B virus (HBV) core protein (HBc) is an essential part of the HBV replication cycle, which is the target for different classes of capsid assembly modulators (CAMs). While both CAM-A ("aberrant") and CAM-E ("empty") disrupt nucleocapsid assembly and reduce extracellular HBV DNA, CAM-As can also reduce extracellular HBV surface antigen (HBsAg) by triggering apoptosis of HBV-infected cells in preclinical mouse models. However, there have not been substantial HBsAg declines in chronic hepatitis B (CHB) patients treated with CAM-As to date. To investigate this disconnect, we characterized the antiviral activity of tool CAM compounds in HBV-infected primary human hepatocytes (PHHs), as well as in HBV-infected human liver chimeric mice and mice transduced with adeno-associated virus-HBV. Mechanistic studies in HBV-infected PHH revealed that CAM-A, but not CAM-E, induced a dose-dependent aggregation of HBc in the nucleus which is negatively regulated by the ubiquitin-binding protein p62. We confirmed that CAM-A, but not CAM-E, induced HBc-positive cell death in both mouse models via induction of apoptotic and inflammatory pathways and demonstrated that the degree of HBV-positive cell loss was positively correlated with intrahepatic HBc levels. Importantly, we determined that there is a significantly lower level of HBc per hepatocyte in CHB patient liver biopsies than in either of the HBV mouse models. Taken together, these data confirm that CAM-As have a unique secondary mechanism with the potential to kill HBc-positive hepatocytes. However, this secondary mechanism appears to require higher intrahepatic HBc levels than is typically observed in CHB patients, thereby limiting the therapeutic potential.
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Affiliation(s)
| | - Zhijuan Song
- Gilead Sciences, Inc., Foster City, California, USA
| | - Stacey Eng
- Gilead Sciences, Inc., Foster City, California, USA
| | | | | | | | - Qin Yue
- Gilead Sciences, Inc., Foster City, California, USA
| | | | - Shiva Zaboli
- Gilead Sciences, Inc., Foster City, California, USA
| | | | - Jane Tam
- Gilead Sciences, Inc., Foster City, California, USA
| | | | | | - Lauri Diehl
- Gilead Sciences, Inc., Foster City, California, USA
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2
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Berke JM, Tan Y, Sauviller S, Wu DT, Zhang K, Conceição-Neto N, Blázquez Moreno A, Kong D, Kukolj G, Li C, Zhu R, Nájera I, Pauwels F. Class A capsid assembly modulator apoptotic elimination of hepatocytes with high HBV core antigen level in vivo is dependent on de novo core protein translation. J Virol 2024; 98:e0150223. [PMID: 38315015 PMCID: PMC10949496 DOI: 10.1128/jvi.01502-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 12/19/2023] [Indexed: 02/07/2024] Open
Abstract
Capsid assembly is critical in the hepatitis B virus (HBV) life cycle, mediated by the viral core protein. Capsid assembly is the target for new anti-viral therapeutics known as capsid assembly modulators (CAMs) of which the CAM-aberrant (CAM-A) class induces aberrant shaped core protein structures and leads to hepatocyte cell death. This study aimed to identify the mechanism of action of CAM-A modulators leading to HBV-infected hepatocyte elimination where CAM-A-mediated hepatitis B surface antigen (HBsAg) reduction was evaluated in a stable HBV replicating cell line and in AAV-HBV-transduced C57BL/6, C57BL/6 SCID, and HBV-infected chimeric mice with humanized livers. Results showed that in vivo treatment with CAM-A modulators induced pronounced reductions in hepatitis B e antigen (HBeAg) and HBsAg, associated with a transient alanine amino transferase (ALT) increase. Both HBsAg and HBeAg reductions and ALT increase were delayed in C57BL/6 SCID and chimeric mice, suggesting that adaptive immune responses may indirectly contribute. However, CD8+ T cell depletion in transduced wild-type mice did not impact antigen reduction, indicating that CD8+ T cell responses are not essential. Transient ALT elevation in AAV-HBV-transduced mice coincided with a transient increase in endoplasmic reticulum stress and apoptosis markers, followed by detection of a proliferation marker. Microarray data revealed antigen presentation pathway (major histocompatibility complex class I molecules) upregulation, overlapping with the apoptosis. Combination treatment with HBV-specific siRNA demonstrated that CAM-A-mediated HBsAg reduction is dependent on de novo core protein translation. To conclude, CAM-A treatment eradicates HBV-infected hepatocytes with high core protein levels through the induction of apoptosis, which can be a promising approach as part of a regimen to achieve functional cure. IMPORTANCE Treatment with hepatitis B virus (HBV) capsid assembly modulators that induce the formation of aberrant HBV core protein structures (CAM-A) leads to programmed cell death, apoptosis, of HBV-infected hepatocytes and subsequent reduction of HBV antigens, which differentiates CAM-A from other CAMs. The effect is dependent on the de novo synthesis and high levels of core protein.
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Affiliation(s)
- Jan Martin Berke
- Infectious Diseases Discovery, Infectious Diseases and Vaccines, Janssen Research and Development, Turnhoutseweg, Beerse, Belgium
| | - Ying Tan
- Infectious Diseases Discovery, Janssen Research and Development, Jinchuang Mansion, Pudong, Shanghai, China
| | - Sarah Sauviller
- Infectious Diseases Discovery, Infectious Diseases and Vaccines, Janssen Research and Development, Turnhoutseweg, Beerse, Belgium
| | - Dai-tze Wu
- Infectious Diseases Discovery, Janssen Research and Development, Jinchuang Mansion, Pudong, Shanghai, China
| | - Ke Zhang
- Infectious Diseases Discovery, Janssen Research and Development, Jinchuang Mansion, Pudong, Shanghai, China
| | - Nádia Conceição-Neto
- Infectious Diseases Discovery, Infectious Diseases and Vaccines, Janssen Research and Development, Turnhoutseweg, Beerse, Belgium
| | - Alfonso Blázquez Moreno
- Infectious Diseases Biomarkers, Infectious Diseases and Vaccines, Janssen Research and Development, Turnhoutseweg, Beerse, Belgium
| | - Desheng Kong
- Infectious Diseases Discovery, Janssen Research and Development, Jinchuang Mansion, Pudong, Shanghai, China
| | - George Kukolj
- Infectious Diseases Discovery, Janssen Research and Development, Brisbane, California, USA
| | - Chris Li
- Infectious Diseases Discovery, Janssen Research and Development, Brisbane, California, USA
| | - Ren Zhu
- Infectious Diseases Discovery, Janssen Research and Development, Jinchuang Mansion, Pudong, Shanghai, China
| | - Isabel Nájera
- Infectious Diseases Discovery, Janssen Research and Development, Brisbane, California, USA
| | - Frederik Pauwels
- Infectious Diseases Discovery, Infectious Diseases and Vaccines, Janssen Research and Development, Turnhoutseweg, Beerse, Belgium
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Zhao Q, Liu H, Tang L, Wang F, Tolufashe G, Chang J, Guo JT. Mechanism of interferon alpha therapy for chronic hepatitis B and potential approaches to improve its therapeutic efficacy. Antiviral Res 2024; 221:105782. [PMID: 38110058 DOI: 10.1016/j.antiviral.2023.105782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 12/11/2023] [Accepted: 12/12/2023] [Indexed: 12/20/2023]
Abstract
Hepatitis B virus (HBV) chronically infects 296 million people worldwide and causes more than 820,000 deaths annually due to cirrhosis and hepatocellular carcinoma. Current standard-of-care medications for chronic hepatitis B (CHB) include nucleos(t)ide analogue (NA) viral DNA polymerase inhibitors and pegylated interferon alpha (PEG-IFN-α). NAs can efficiently suppress viral replication and improve liver pathology, but not eliminate or inactivate HBV covalently closed circular DNA (cccDNA). CCC DNA is the most stable HBV replication intermediate that exists as a minichromosome in the nucleus of infected hepatocyte to transcribe viral RNA and support viral protein translation and genome replication. Consequentially, a finite duration of NA therapy rarely achieves a sustained off-treatment suppression of viral replication and life-long NA treatment is most likely required. On the contrary, PEG-IFN-α has the benefit of finite treatment duration and achieves HBsAg seroclearance, the indication of durable immune control of HBV replication and functional cure of CHB, in approximately 5% of treated patients. However, the low antiviral efficacy and poor tolerability limit its use. Understanding how IFN-α suppresses HBV replication and regulates antiviral immune responses will help rational optimization of IFN therapy and development of novel immune modulators to improve the rate of functional cure. This review article highlights mechanistic insight on IFN control of HBV infection and recent progress in development of novel IFN regimens, small molecule IFN mimetics and combination therapy of PEG-IFN-α with new direct-acting antivirals and therapeutic vaccines to facilitate the functional cure of CHB.
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Affiliation(s)
- Qiong Zhao
- Baruch S. Blumberg Institute, Doylestown, PA, United States
| | - Hui Liu
- Baruch S. Blumberg Institute, Doylestown, PA, United States
| | - Liudi Tang
- Baruch S. Blumberg Institute, Doylestown, PA, United States
| | - Fuxuan Wang
- Baruch S. Blumberg Institute, Doylestown, PA, United States
| | | | - Jinhong Chang
- Baruch S. Blumberg Institute, Doylestown, PA, United States
| | - Ju-Tao Guo
- Baruch S. Blumberg Institute, Doylestown, PA, United States.
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4
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Zhao S, Wang Y, Zhang X, Qiao L, Wang S, Jin Y, Wu S, Li Y, Zhan P, Liu X. Discovery of carboxyl-containing heteroaryldihydropyrimidine derivatives as novel HBV capsid assembly modulators with significantly improved metabolic stability. RSC Med Chem 2023; 14:2380-2400. [PMID: 37974964 PMCID: PMC10650354 DOI: 10.1039/d3md00461a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 09/30/2023] [Indexed: 11/19/2023] Open
Abstract
Interfering with the assembly of hepatitis B virus (HBV) capsid is a promising approach for treating chronic hepatitis B (CHB). In order to enhance the metabolic stability and reduce the strong hERG inhibitory effect of HBV capsid assembly modulator (CAM) GLS4, we rationally designed a series of carboxyl-containing heteroaryldihydropyrimidine (HAP) derivatives based on structural biology information combined with medicinal chemistry strategies. The results from biological evaluation demonstrated that compound 6a-25 (EC50 = 0.020 μM) exhibited greater potency than the positive drug lamivudine (EC50 = 0.09 μM), and was comparable to the lead compound GLS4 (EC50 = 0.007 μM). Furthermore, it was observed that 6a-25 reduced levels of core protein (Cp) and capsid in cells. Preliminary assessment of drug-likeness revealed that 6a-25 exhibited superior water solubility (pH 2.0: 374.81 μg mL-1; pH 7.0: 6.85 μg mL-1; pH 7.4: 25.48 μg mL-1), liver microsomal metabolic stability (t1/2 = 108.2 min), and lower hERG toxicity (10 μM inhibition rate was 72.66%) compared to the lead compound GLS4. Overall, compound 6a-25 holds promise for further investigation.
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Affiliation(s)
- Shujie Zhao
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology, Ministry of Education, School of Pharmaceutical Sciences, Shandong University 44 West Culture Road 250012 Jinan Shandong PR China
| | - Ya Wang
- CAMS Key Laboratory of Antiviral Drug Research, Beijing Key Laboratory of Antimicrobial Agents, NHC Key Laboratory of Biotechnology of Antibiotics, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College 100050 Beijing PR China
| | - Xujie Zhang
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology, Ministry of Education, School of Pharmaceutical Sciences, Shandong University 44 West Culture Road 250012 Jinan Shandong PR China
| | - Lijun Qiao
- CAMS Key Laboratory of Antiviral Drug Research, Beijing Key Laboratory of Antimicrobial Agents, NHC Key Laboratory of Biotechnology of Antibiotics, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College 100050 Beijing PR China
| | - Shuo Wang
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology, Ministry of Education, School of Pharmaceutical Sciences, Shandong University 44 West Culture Road 250012 Jinan Shandong PR China
| | - Yu Jin
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology, Ministry of Education, School of Pharmaceutical Sciences, Shandong University 44 West Culture Road 250012 Jinan Shandong PR China
| | - Shuo Wu
- CAMS Key Laboratory of Antiviral Drug Research, Beijing Key Laboratory of Antimicrobial Agents, NHC Key Laboratory of Biotechnology of Antibiotics, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College 100050 Beijing PR China
| | - Yuhuan Li
- CAMS Key Laboratory of Antiviral Drug Research, Beijing Key Laboratory of Antimicrobial Agents, NHC Key Laboratory of Biotechnology of Antibiotics, Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College 100050 Beijing PR China
| | - Peng Zhan
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology, Ministry of Education, School of Pharmaceutical Sciences, Shandong University 44 West Culture Road 250012 Jinan Shandong PR China
| | - Xinyong Liu
- Department of Medicinal Chemistry, Key Laboratory of Chemical Biology, Ministry of Education, School of Pharmaceutical Sciences, Shandong University 44 West Culture Road 250012 Jinan Shandong PR China
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Vanrusselt H, Kum DB, Taverniti V, Liu C, Acosta Sanchez A, Corthout N, Munck S, Baumert TF, Beigelman L, Blatt LM, Symons JA, Deval J, Raboisson P, Verrier ER, Jekle A, Vendeville S, Debing Y. Novel non-HAP class A HBV capsid assembly modulators have distinct in vitro and in vivo profiles. J Virol 2023; 97:e0072223. [PMID: 37754761 PMCID: PMC10617565 DOI: 10.1128/jvi.00722-23] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/08/2023] [Indexed: 09/28/2023] Open
Abstract
IMPORTANCE Chronic hepatitis B is the most important cause of liver cancer worldwide and affects more than 290 million people. Current treatments are mostly suppressive and rarely lead to a cure. Therefore, there is a need for novel and curative drugs that target the host or the causative agent, hepatitis B virus itself. Capsid assembly modulators are an interesting class of antiviral molecules that may one day become part of curative treatment regimens for chronic hepatitis B. Here we explore the characteristics of a particularly interesting subclass of capsid assembly modulators. These so-called non-HAP CAM-As have intriguing properties in cell culture but also clear virus-infected cells from the mouse liver in a gradual and sustained way. We believe they represent a considerable improvement over previously reported molecules and may one day be part of curative treatment combinations for chronic hepatitis B.
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Affiliation(s)
| | - Dieudonné Buh Kum
- Aligos Belgium BV, Leuven, Belgium
- Aligos Therapeutics, Inc., South San Francisco, California, USA
| | - Valerio Taverniti
- Inserm, Institut de Recherche sur les Maladies Virales et Hépatiques UMR S1110, Université de Strasbourg, Strasbourg, France
| | - Cheng Liu
- Aligos Therapeutics, Inc., South San Francisco, California, USA
| | | | | | | | - Thomas F. Baumert
- Inserm, Institut de Recherche sur les Maladies Virales et Hépatiques UMR S1110, Université de Strasbourg, Strasbourg, France
- Service d’Hépato-gastroenterologie, Pôle Hépato-digestif, IHU Strasbourg, Strasbourg University Hospitals, Strasbourg, France
| | | | | | | | - Jerome Deval
- Aligos Therapeutics, Inc., South San Francisco, California, USA
| | | | - Eloi R. Verrier
- Inserm, Institut de Recherche sur les Maladies Virales et Hépatiques UMR S1110, Université de Strasbourg, Strasbourg, France
| | - Andreas Jekle
- Aligos Therapeutics, Inc., South San Francisco, California, USA
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6
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Basit L, Amblard F, Patel DJ, Biteau N, Chen Z, Kasthuri M, Zhou S, Schinazi RF. The premise of capsid assembly modulators towards eliminating HBV persistence. Expert Opin Drug Discov 2023; 18:1031-1041. [PMID: 37477111 PMCID: PMC10530454 DOI: 10.1080/17460441.2023.2239701] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/19/2023] [Indexed: 07/22/2023]
Abstract
INTRODUCTION The burden of chronic hepatitis B virus (HBV) results in almost a million deaths per year. The most common treatment for chronic hepatitis B infection is long-term nucleoside analogs (NUC) or one-year interferon-alpha (pegylated or non-pegylated) therapy before or after NUC therapy. Unfortunately, these therapies rarely result in HBV functional cure because they do not eradicate HBV from the nucleus of the hepatocytes, where the covalently closed circular DNA (cccDNA) is formed and/or where the integrated HBV DNA persists in the host genome. Hence, the search continues for novel antiviral therapies that target different steps of the HBV replication cycle to cure chronically infected HBV individuals and eliminate HBV from the liver reservoirs. AREAS COVERED The authors focus on capsid assembly modulators (CAMs). These molecules are unique because they impact not only one but several steps of HBV viral replication, including capsid assembly, capsid trafficking into the nucleus, reverse transcription, pre-genomic RNA (pgRNA), and polymerase protein co-packaging. EXPERT OPINION Mono- or combination therapy, including CAMs with other HBV drugs, may potentially eliminate hepatitis B infections. Nevertheless, more data on their potential effect on HBV elimination is needed, especially when used daily for 6-12 months.
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Affiliation(s)
- Leda Basit
- Center for ViroScience and Cure, Laboratory of Biochemical
Pharmacology, Department of Pediatrics, Emory University School of Medicine and
Children’s Healthcare of Atlanta, 1760 Haygood Drive, Atlanta, GA 30322,
USA
| | - Franck Amblard
- Center for ViroScience and Cure, Laboratory of Biochemical
Pharmacology, Department of Pediatrics, Emory University School of Medicine and
Children’s Healthcare of Atlanta, 1760 Haygood Drive, Atlanta, GA 30322,
USA
| | - Dharmeshkumar J. Patel
- Center for ViroScience and Cure, Laboratory of Biochemical
Pharmacology, Department of Pediatrics, Emory University School of Medicine and
Children’s Healthcare of Atlanta, 1760 Haygood Drive, Atlanta, GA 30322,
USA
| | - Nicolas Biteau
- Center for ViroScience and Cure, Laboratory of Biochemical
Pharmacology, Department of Pediatrics, Emory University School of Medicine and
Children’s Healthcare of Atlanta, 1760 Haygood Drive, Atlanta, GA 30322,
USA
| | - Zhe Chen
- Center for ViroScience and Cure, Laboratory of Biochemical
Pharmacology, Department of Pediatrics, Emory University School of Medicine and
Children’s Healthcare of Atlanta, 1760 Haygood Drive, Atlanta, GA 30322,
USA
| | - Mahesh Kasthuri
- Center for ViroScience and Cure, Laboratory of Biochemical
Pharmacology, Department of Pediatrics, Emory University School of Medicine and
Children’s Healthcare of Atlanta, 1760 Haygood Drive, Atlanta, GA 30322,
USA
| | - Shaoman Zhou
- Center for ViroScience and Cure, Laboratory of Biochemical
Pharmacology, Department of Pediatrics, Emory University School of Medicine and
Children’s Healthcare of Atlanta, 1760 Haygood Drive, Atlanta, GA 30322,
USA
| | - Raymond F. Schinazi
- Center for ViroScience and Cure, Laboratory of Biochemical
Pharmacology, Department of Pediatrics, Emory University School of Medicine and
Children’s Healthcare of Atlanta, 1760 Haygood Drive, Atlanta, GA 30322,
USA
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