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Loureiro D, Tout I, Narguet S, Bed CM, Roinard M, Sleiman A, Boyer N, Pons‐Kerjean N, Castelnau C, Giuly N, Tonui D, Soumelis V, El Benna J, Soussan P, Moreau R, Paradis V, Mansouri A, Asselah T. Mitochondrial stress in advanced fibrosis and cirrhosis associated with chronic hepatitis B, chronic hepatitis C, or nonalcoholic steatohepatitis. Hepatology 2023; 77:1348-1365. [PMID: 35971873 PMCID: PMC10026976 DOI: 10.1002/hep.32731] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 07/20/2022] [Accepted: 08/08/2022] [Indexed: 12/08/2022]
Abstract
BACKGROUND AND AIMS Hepatitis B virus (HBV) infection causes oxidative stress (OS) and alters mitochondria in experimental models. Our goal was to investigate whether HBV might alter liver mitochondria also in humans, and the resulting mitochondrial stress might account for the progression of fibrosis in chronic hepatitis B (CHB). APPROACH AND RESULTS The study included 146 treatment-naïve CHB mono-infected patients. Patients with CHB and advanced fibrosis (AF) or cirrhosis (F3-F4) were compared to patients with no/mild-moderate fibrosis (F0-F2). Patients with CHB were further compared to patients with chronic hepatitis C (CHC; n = 33), nonalcoholic steatohepatatis (NASH; n = 12), and healthy controls ( n = 24). We detected oxidative damage to mitochondrial DNA (mtDNA), including mtDNA strand beaks, and identified multiple mtDNA deletions in patients with F3-F4 as compared to patients with F0-F2. Alterations in mitochondrial function, mitochondrial unfolded protein response, biogenesis, mitophagy, and liver inflammation were observed in patients with AF or cirrhosis associated with CHB, CHC, and NASH. In vitro , significant increases of the mitochondrial formation of superoxide and peroxynitrite as well as mtDNA damage, nitration of the mitochondrial respiratory chain complexes, and impairment of complex I occurred in HepG2 cells replicating HBV or transiently expressing hepatitits B virus X protein. mtDNA damage and complex I impairment were prevented with the superoxide-scavenging Mito-Tempo or with inducible nitric oxide synthase (iNOS)-specific inhibitor 1400 W. CONCLUSIONS Our results emphasized the importance of mitochondrial OS, mtDNA damage, and associated alterations in mitochondrial function and dynamics in AF or cirrhosis in CHB and NASH. Mitochondria might be a target in drug development to stop fibrosis progression.
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Affiliation(s)
- Dimitri Loureiro
- Université Paris Cité, Centre de Recherche sur l'Inflammation, INSERM U1149, CNRS ERL8252, Paris, France
- Assistance Publique‐Hôpitaux de Paris (AP‐HP), Department of Hepatology, Hôpital Beaujon, Clichy, France
| | - Issam Tout
- Université Paris Cité, Centre de Recherche sur l'Inflammation, INSERM U1149, CNRS ERL8252, Paris, France
- Assistance Publique‐Hôpitaux de Paris (AP‐HP), Department of Hepatology, Hôpital Beaujon, Clichy, France
| | - Stéphanie Narguet
- Université Paris Cité, Centre de Recherche sur l'Inflammation, INSERM U1149, CNRS ERL8252, Paris, France
- Assistance Publique‐Hôpitaux de Paris (AP‐HP), Department of Hepatology, Hôpital Beaujon, Clichy, France
| | - Cheikh Mohamed Bed
- Université Paris Cité, Centre de Recherche sur l'Inflammation, INSERM U1149, CNRS ERL8252, Paris, France
- Assistance Publique‐Hôpitaux de Paris (AP‐HP), Department of Hepatology, Hôpital Beaujon, Clichy, France
| | - Morgane Roinard
- Université Paris Cité, Centre de Recherche sur l'Inflammation, INSERM U1149, CNRS ERL8252, Paris, France
- Assistance Publique‐Hôpitaux de Paris (AP‐HP), Department of Hepatology, Hôpital Beaujon, Clichy, France
| | - Ahmad Sleiman
- Université Paris Cité, Centre de Recherche sur l'Inflammation, INSERM U1149, CNRS ERL8252, Paris, France
- Assistance Publique‐Hôpitaux de Paris (AP‐HP), Department of Hepatology, Hôpital Beaujon, Clichy, France
| | - Nathalie Boyer
- Université Paris Cité, Centre de Recherche sur l'Inflammation, INSERM U1149, CNRS ERL8252, Paris, France
- Assistance Publique‐Hôpitaux de Paris (AP‐HP), Department of Hepatology, Hôpital Beaujon, Clichy, France
| | - Nathalie Pons‐Kerjean
- Assistance Publique‐Hôpitaux de Paris (AP‐HP), Department of Pharmacy, Hôpital Beaujon, Clichy, France
| | - Corinne Castelnau
- Université Paris Cité, Centre de Recherche sur l'Inflammation, INSERM U1149, CNRS ERL8252, Paris, France
- Assistance Publique‐Hôpitaux de Paris (AP‐HP), Department of Hepatology, Hôpital Beaujon, Clichy, France
| | - Nathalie Giuly
- Université Paris Cité, Centre de Recherche sur l'Inflammation, INSERM U1149, CNRS ERL8252, Paris, France
- Assistance Publique‐Hôpitaux de Paris (AP‐HP), Department of Hepatology, Hôpital Beaujon, Clichy, France
| | - Dorothy Tonui
- Université Paris Cité, Centre de Recherche sur l'Inflammation, INSERM U1149, CNRS ERL8252, Paris, France
- Assistance Publique‐Hôpitaux de Paris (AP‐HP), Department of Hepatology, Hôpital Beaujon, Clichy, France
| | - Vassili Soumelis
- Université de Paris Cité, INSERM U976 HIPI Unit, Paris, France
- Assistance Publique‐Hôpitaux de Paris (AP‐HP), Laboratoire d'Immunologie et Histocompatibilité, Hôpital Saint‐Louis, Paris, France
| | - Jamel El Benna
- Université Paris Cité, Centre de Recherche sur l'Inflammation, INSERM U1149, CNRS ERL8252, Paris, France
| | | | - Richard Moreau
- Université Paris Cité, Centre de Recherche sur l'Inflammation, INSERM U1149, CNRS ERL8252, Paris, France
- Assistance Publique‐Hôpitaux de Paris (AP‐HP), Department of Hepatology, Hôpital Beaujon, Clichy, France
| | - Valérie Paradis
- Université Paris Cité, Centre de Recherche sur l'Inflammation, INSERM U1149, CNRS ERL8252, Paris, France
- Assistance Publique‐Hôpitaux de Paris (AP‐HP), Department of Hepatology, Hôpital Beaujon, Clichy, France
| | - Abdellah Mansouri
- Université Paris Cité, Centre de Recherche sur l'Inflammation, INSERM U1149, CNRS ERL8252, Paris, France
- Assistance Publique‐Hôpitaux de Paris (AP‐HP), Department of Hepatology, Hôpital Beaujon, Clichy, France
| | - Tarik Asselah
- Université Paris Cité, Centre de Recherche sur l'Inflammation, INSERM U1149, CNRS ERL8252, Paris, France
- Assistance Publique‐Hôpitaux de Paris (AP‐HP), Department of Hepatology, Hôpital Beaujon, Clichy, France
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Asselah T, Loureiro D, Le Gal F, Narguet S, Brichler S, Bouton V, Abazid M, Boyer N, Giuly N, Gerber A, Tout I, Maylin S, Bed CM, Marcellin P, Castelnau C, Gordien E, Mansouri A. Early virological response in six patients with hepatitis D virus infection and compensated cirrhosis treated with Bulevirtide in real-life. Liver Int 2021; 41:1509-1517. [PMID: 33999515 DOI: 10.1111/liv.14950] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/03/2021] [Accepted: 05/10/2021] [Indexed: 12/17/2022]
Abstract
Hepatitis delta virus (HDV) infection is the most severe form of viral hepatitis. Bulevirtide (BLV, Hepcludex® ) is an HDV/HBV entry inhibitor approved in June 2020 in the European Union for adult patients with chronic hepatitis delta (CHD) and compensated liver disease and positive HDV RNA viral load. This real-life preliminary report described early virological efficacy and safety of BLV in six patients with CHD and compensated liver disease: four patients were treated with the combination of BLV (2 mg/d in subcutaneous injection) and pegylated interferon (PEG-IFN) and two patients with BLV monotherapy. Four patients treated with combined therapy had a decline of a minimum of 1 log10 and 3/3 of 2 log10 of HDV-VL at 12 and 24 weeks, respectively. One patient among four had stopped the treatment at 12 weeks because of thrombocytopenia and an HDV-VL relapse was notified 24 weeks after treatment cessation. Three patients among four (3/4) had undetectable HDV-VL during the therapy (<100 IU/ml). One patient (1/2) treated with BLV monotherapy had a decline of HDV-VL by 1 log10 at 8 weeks and 1/1 by 2 log10 at 28 week on-treatment. Two patients among four (2/4) with combined therapy had normal ALT reached at 4 and 56 weeks. One patient (1/2) with BLV monotherapy achieves ALT normalization at 4 weeks on treatment. Hepatitis B surface antigen (HBsAg) levels remain unchanged. Three among six (3/6) patients had an elevation of total biliary acids without pruritus. These early data generated confirm the interest in this new treatment. Final results will be important to demonstrate long-term clinical benefit (fibrosis reversibility and reduction in hepato-cellular carcinoma [HCC]).
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Affiliation(s)
- Tarik Asselah
- Centre de recherche sur l'inflammation, Université́ de Paris, Inserm U1149, CNRS ERL8252, Paris, France.,Department of Hepatology, AP-HP, Hôpital Beaujon, Clichy, France
| | - Dimitri Loureiro
- Centre de recherche sur l'inflammation, Université́ de Paris, Inserm U1149, CNRS ERL8252, Paris, France.,Department of Hepatology, AP-HP, Hôpital Beaujon, Clichy, France
| | - Fréderic Le Gal
- Laboratoire de Microbiologie Clinique, Centre National de référence des Hépatites B, C et Delta, Université de Paris 13, Inserm U955, AP-HP, Hôpital Avicenne, Bobigny, France
| | - Stéphanie Narguet
- Centre de recherche sur l'inflammation, Université́ de Paris, Inserm U1149, CNRS ERL8252, Paris, France.,Department of Hepatology, AP-HP, Hôpital Beaujon, Clichy, France
| | - Ségolène Brichler
- Laboratoire de Microbiologie Clinique, Centre National de référence des Hépatites B, C et Delta, Université de Paris 13, Inserm U955, AP-HP, Hôpital Avicenne, Bobigny, France
| | - Valérie Bouton
- Service de Pharmacie, Université́ de Paris, AP-HP, Hôpital Beaujon, Clichy, France
| | - Malek Abazid
- Service de Pharmacie, Université́ de Paris, AP-HP, Hôpital Beaujon, Clichy, France
| | - Nathalie Boyer
- Centre de recherche sur l'inflammation, Université́ de Paris, Inserm U1149, CNRS ERL8252, Paris, France.,Department of Hepatology, AP-HP, Hôpital Beaujon, Clichy, France
| | - Nathalie Giuly
- Centre de recherche sur l'inflammation, Université́ de Paris, Inserm U1149, CNRS ERL8252, Paris, France.,Department of Hepatology, AP-HP, Hôpital Beaujon, Clichy, France
| | - Athenais Gerber
- Laboratoire de Microbiologie Clinique, Centre National de référence des Hépatites B, C et Delta, Université de Paris 13, Inserm U955, AP-HP, Hôpital Avicenne, Bobigny, France
| | - Issam Tout
- Centre de recherche sur l'inflammation, Université́ de Paris, Inserm U1149, CNRS ERL8252, Paris, France.,Department of Hepatology, AP-HP, Hôpital Beaujon, Clichy, France
| | - Sarah Maylin
- Laboratoire de Microbiologie, Université de Paris, AP-HP, Hôpital Saint-Louis, Paris, France
| | - Cheikh M Bed
- Centre de recherche sur l'inflammation, Université́ de Paris, Inserm U1149, CNRS ERL8252, Paris, France.,Department of Hepatology, AP-HP, Hôpital Beaujon, Clichy, France
| | - Patrick Marcellin
- Centre de recherche sur l'inflammation, Université́ de Paris, Inserm U1149, CNRS ERL8252, Paris, France.,Department of Hepatology, AP-HP, Hôpital Beaujon, Clichy, France
| | - Corinne Castelnau
- Centre de recherche sur l'inflammation, Université́ de Paris, Inserm U1149, CNRS ERL8252, Paris, France.,Department of Hepatology, AP-HP, Hôpital Beaujon, Clichy, France
| | - Emmanuel Gordien
- Laboratoire de Microbiologie Clinique, Centre National de référence des Hépatites B, C et Delta, Université de Paris 13, Inserm U955, AP-HP, Hôpital Avicenne, Bobigny, France
| | - Abdellah Mansouri
- Centre de recherche sur l'inflammation, Université́ de Paris, Inserm U1149, CNRS ERL8252, Paris, France.,Department of Hepatology, AP-HP, Hôpital Beaujon, Clichy, France
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Loureiro D, Castelnau C, Tout I, Boyer N, Narguet S, Menasria Benazzouz S, Louis Z, Pons-Kerjean N, Giuly N, Marcellin P, Mansouri A, Asselah T. New therapies for hepatitis delta virus infection. Liver Int 2021; 41 Suppl 1:30-37. [PMID: 34155804 DOI: 10.1111/liv.14838] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 02/22/2021] [Indexed: 12/11/2022]
Abstract
Hepatitis delta virus (HDV) infection is a defective virus requiring hepatitis B virus (HBV) for its complete replication cycle. HDV is a small hepatotropic RNA virus and around 15 to 25 million people worldwide are living with chronic hepatitis delta (CHD) infection. However, the prevalence of HDV may be underestimated, and screening is frequently insufficient. HDV infection remains endemic in several regions including Central and West Africa, the Mediterranean basin, the Middle East, Eastern Europe, Northern Asia, certain areas of Southeast Asia and the Amazon basin of South America. The best preventive strategy to decrease HDV infection is to improve coverage of the prophylactic HBV vaccine. HDV infection may occur by HBV-HDV co-infection or superinfection, and the latter is usually more severe. CHD is associated with a higher risk of cirrhosis and hepatocellular carcinoma (HCC) compared to HBV mono-infection. Pegylated interferon alpha (PEG-IFNα) therapy is limited by moderate effectiveness (around 20%) and its adverse effects. The entry inhibitor, bulevirtide (BLV, Hepcludex® ), which was recently approved in Europe at a dose of 2 mg in sub-cutaneous injection per day, is indicated for the treatment of CHD in adult patients with compensated liver disease and positive HDV viremia. BLV can be administrated in monotherapy or in combination with PEG-IFNα. Nucleos(t)ide analogues can be used in combination for underlying HBV infection. The optimal treatment duration has not yet been determined and treatment should be continued if a clinical benefit is observed. There are other promising therapies such as IFN lambda (IFNλ) (immunomodulator), lonafarnib (prenylation inhibitor) and nucleic acid polymers (Inhibitors of HBsAg release). In this review, we will present an update on CHD and future promising treatments.
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Affiliation(s)
- Dimitri Loureiro
- Centre de recherche sur l'inflammation, Université de Paris, Inserm, CNRS, Paris, France.,Department of Hepatology, AP-HP, Hôpital Beaujon, Clichy, France
| | - Corinne Castelnau
- Centre de recherche sur l'inflammation, Université de Paris, Inserm, CNRS, Paris, France.,Department of Hepatology, AP-HP, Hôpital Beaujon, Clichy, France
| | - Issam Tout
- Centre de recherche sur l'inflammation, Université de Paris, Inserm, CNRS, Paris, France.,Department of Hepatology, AP-HP, Hôpital Beaujon, Clichy, France
| | - Nathalie Boyer
- Centre de recherche sur l'inflammation, Université de Paris, Inserm, CNRS, Paris, France.,Department of Hepatology, AP-HP, Hôpital Beaujon, Clichy, France
| | - Stéphanie Narguet
- Centre de recherche sur l'inflammation, Université de Paris, Inserm, CNRS, Paris, France.,Department of Hepatology, AP-HP, Hôpital Beaujon, Clichy, France
| | - Sabrina Menasria Benazzouz
- Centre de recherche sur l'inflammation, Université de Paris, Inserm, CNRS, Paris, France.,Department of Hepatology, AP-HP, Hôpital Beaujon, Clichy, France
| | - Zeina Louis
- Centre de recherche sur l'inflammation, Université de Paris, Inserm, CNRS, Paris, France.,Service de Pharmacie, AP-HP, Hôpital Beaujon, Clichy, France
| | - Nathalie Pons-Kerjean
- Centre de recherche sur l'inflammation, Université de Paris, Inserm, CNRS, Paris, France.,Service de Pharmacie, AP-HP, Hôpital Beaujon, Clichy, France
| | - Nathalie Giuly
- Centre de recherche sur l'inflammation, Université de Paris, Inserm, CNRS, Paris, France.,Department of Hepatology, AP-HP, Hôpital Beaujon, Clichy, France
| | - Patrick Marcellin
- Centre de recherche sur l'inflammation, Université de Paris, Inserm, CNRS, Paris, France.,Department of Hepatology, AP-HP, Hôpital Beaujon, Clichy, France
| | - Abdellah Mansouri
- Centre de recherche sur l'inflammation, Université de Paris, Inserm, CNRS, Paris, France.,Department of Hepatology, AP-HP, Hôpital Beaujon, Clichy, France
| | - Tarik Asselah
- Centre de recherche sur l'inflammation, Université de Paris, Inserm, CNRS, Paris, France.,Department of Hepatology, AP-HP, Hôpital Beaujon, Clichy, France
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