NASH
Mice models
https://www.ncbi.nlm.nih.gov/pubmed/19603542
CCR1 and CCR5 promote hepatic fibrosis in mice
https://academic.oup.com/jac/article/69/7/1903/2911132
Maraviroc, a CCR5 antagonist, ameliorates the development of hepatic steatosis in a mouse model of non-alcoholic fatty liver disease (NAFLD)
https://www.translationalres.com/article/S193...0177-3/pdf
Steatosis induced CCL5 contributes to early-stage liver fibrosis in nonalcoholic fatty liver disease progress
Clinical Trials
Cenicriviroc A dual ccr2/Ccr5 inhibitor is in a phase 3 trial.
Phase 2 results
https://www.ncbi.nlm.nih.gov/pubmed/28833331
http://www.isrctn.com/ISRCTN1541081
Investigating the impact of Maraviroc on liver inflammation in patients with HIV and fatty liver disease
Mice models
https://www.ncbi.nlm.nih.gov/pubmed/19603542
CCR1 and CCR5 promote hepatic fibrosis in mice
https://academic.oup.com/jac/article/69/7/1903/2911132
Maraviroc, a CCR5 antagonist, ameliorates the development of hepatic steatosis in a mouse model of non-alcoholic fatty liver disease (NAFLD)
Quote:The findings of our study provide evidence that maraviroc has a protective effect on the development of NAFLD. Owing to the fact that maraviroc has a preventive role in liver damage,22 we believe that maraviroc could be an essential antiretroviral drug in HCV/HIV or HIV-infected patients with liver damage (i.e. hepatic steatosis). These data could justify a randomized, controlled trial in order to determine the beneficial effects of maraviroc on the progression of NAFLD.
https://www.translationalres.com/article/S193...0177-3/pdf
Steatosis induced CCL5 contributes to early-stage liver fibrosis in nonalcoholic fatty liver disease progress
Quote:The rapidly increasing prevalence of nonalcoholic fatty liver disease (NAFLD) has become one of the major public health threats in China and worldwide. However, during the development of NAFLD, the key mechanism underlying the progression of related fibrosis remains unclear, which greatly impedes the development of optimal NAFLD therapy. In the current study, we were endeavored to characterize a proinflammatory cytokine, CCL5, as a major contributor for fibrosis in NAFLD. The results showed that CCL5 was highly expressed in fatty liver and NASH patients. In NAFLD rats induced by 8-week-HFD, CCL5 and its receptor, CCR5, were significantly up-regulated and liver fibrosis exclusively occurred in this group. In addition, we showed that hepatocytes are the major source contributing to this CCL5 elevation. Interestingly, a CCL5 inhibitor Met-CCL5, significantly decreased liver fibrosis but not hepatic steatosis. Using a cell model of hepatic steatosis, we found that the conditioned medium of lipid-overloaded hepatocytes (Fa2N-4 cells) which produced excessive CCL5 stimulated the profibrotic activities of hepatic stellate cells (LX-2) as manifested by increased migration rate, proliferation and collagen production of LX-2 cells. CCL5 knockdown in Fa2N-4 cells, Met-CCL5 or CCR5 antibody treatment on LX-2 cells all significantly inhibited the conditioned medium of FFA-treated Fa2N-4 cells to exert stimulatory effects on LX-2 cells. Consistently, the conditioned medium of Fa2N-4 cells with CCL5 over-expression significantly enhanced migration rate, cell proliferation and collagen production of LX-2 cells. All these results support that CCL5 produced by steatotic hepatocytes plays an essential role in fibrotic signaling machinery of NAFLD. In addition, we were able to identify C/EBP-β as the up-stream regulator of CCL5 gene transcription in hepatocytes treated with free fatty acid (FFA). Our data strongly supported that CCL5 plays a pivotal regulatory role in hepatic fibrosis during NAFLD, which constitutes a novel and exciting observation that may call for potential future development of specific CCL5-targeted NAFLD therapy.
Clinical Trials
Cenicriviroc A dual ccr2/Ccr5 inhibitor is in a phase 3 trial.
Phase 2 results
https://www.ncbi.nlm.nih.gov/pubmed/28833331
Quote:
The aim of this study was to evaluate cenicriviroc (CVC), a dual antagonist of CC chemokine receptor types 2 and 5, for treatment of nonalcoholic steatohepatitis (NASH) with liver fibrosis (LF). A randomized, double-blind, multinational phase 2b study enrolled subjects with NASH, a nonalcoholic fatty liver disease activity score (NAS) ≥4, and LF (stages 1-3, NASH Clinical Research Network) at 81 clinical sites. Subjects (N = 289) were randomly assigned CVC 150 mg or placebo. Primary outcome was ≥2-point improvement in NAS and no worsening of fibrosis at year 1. Key secondary outcomes were: resolution of steatohepatitis (SH) and no worsening of fibrosis; improvement in fibrosis by ≥1 stage and no worsening of SH. Biomarkers of inflammation and adverse events were assessed. Full study recruitment was achieved. The primary endpoint of NAS improvement in the intent-to-treat population and resolution of SH was achieved in a similar proportion of subjects on CVC (N = 145) and placebo (N = 144; 16% vs. 19%, P = 0.52 and 8% vs. 6%, P = 0.49, respectively). However, the fibrosis endpoint was met in significantly more subjects on CVC than placebo (20% vs. 10%; P = 0.02). Treatment benefits were greater in those with higher disease activity and fibrosis stage at baseline. Biomarkers of systemic inflammation were reduced with CVC. Safety and tolerability of CVC were comparable to placebo.
CONCLUSION:
After 1 year of CVC treatment, twice as many subjects achieved improvement in fibrosis and no worsening of SH compared with placebo. Given the urgent need to develop antifibrotic therapies in NASH, these findings warrant phase 3 evaluation. (Hepatology 2018;67:1754-1767).
http://www.isrctn.com/ISRCTN1541081
Investigating the impact of Maraviroc on liver inflammation in patients with HIV and fatty liver disease
