BET Inhibition Improves NASH and Liver Fibrosis

Sci Rep. 2018 Nov 22;8(1):17257. doi: 10.1038/s41598-018-35653-4.

Abstract

Non-alcoholic fatty liver disease (NAFLD) is a leading form of chronic liver disease with large unmet need. Non-alcoholic steatohepatitis (NASH), a progressive variant of NAFLD, can lead to fibrosis, cirrhosis, and hepatocellular carcinoma. To identify potential new therapeutics for NASH, we used a computational approach based on Connectivity Map (CMAP) analysis, which pointed us to bromodomain and extra-terminal motif (BET) inhibitors for treating NASH. To experimentally validate this hypothesis, we tested a small-molecule inhibitor of the BET family of proteins, GSK1210151A (I-BET151), in the STAM mouse NASH model at two different dosing timepoints (onset of NASH and progression to fibrosis). I-BET151 decreased the non-alcoholic fatty liver disease activity score (NAS), a clinical endpoint for assessing the severity of NASH, as well as progression of liver fibrosis and interferon-γ expression. Transcriptional characterization of these mice through RNA-sequencing was consistent with predictions from the CMAP analysis of a human NASH signature and pointed to alterations in molecular mechanisms related to interferon signaling and cholesterol biosynthesis, as well as reversal of gene expression patterns linked to fibrotic markers. Altogether, these results suggest that inhibition of BET proteins may present a novel therapeutic opportunity in the treatment of NASH and liver fibrosis.

MeSH terms

  • Animals
  • Cholesterol / biosynthesis
  • Computational Biology / methods*
  • Disease Models, Animal
  • Disease Progression
  • Gene Expression Profiling
  • Gene Expression Regulation / drug effects
  • Gene Regulatory Networks / drug effects*
  • Heterocyclic Compounds, 4 or More Rings / administration & dosage*
  • Heterocyclic Compounds, 4 or More Rings / pharmacology
  • Humans
  • Interferon-gamma / metabolism
  • Liver Cirrhosis / drug therapy*
  • Liver Cirrhosis / genetics
  • Liver Cirrhosis / immunology
  • Mice
  • Non-alcoholic Fatty Liver Disease / drug therapy*
  • Non-alcoholic Fatty Liver Disease / genetics
  • Non-alcoholic Fatty Liver Disease / immunology
  • Sequence Analysis, RNA
  • Severity of Illness Index

Substances

  • GSK1210151A
  • Heterocyclic Compounds, 4 or More Rings
  • Interferon-gamma
  • Cholesterol