Use of agents capable of inducing lc3-associated phagocytosis for treating sustained inflammation in patients suffering from chronic liver disease

Sustained hepatic and systemic inflammation, in particular originating from monocyte/macrophages, is a driving force for chronic liver disease progression to cirrhosis and underlies the development of multiorgan failure. Therefore, reprogramming monocyte/macrophage phenotype has emerged as an interesting strategy to limit inflammation during chronic liver injury. The inventors report here that a non-canonical form of autophagy, LC3-associated phagocytosis (LAP), is endogenously enhanced in blood and liver monocytes from cirrhotic patients and is negatively correlated to the levels of inflammatory markers in these patients. Pharmacological inhibition of LAP components or genetic disruption of LAP (Rubicon-deficient mice in myeloid cells), exacerbates the inflammatory signature in isolated human cirrhotic monocytes and the hepatic inflammatory profile in mice with chronic liver injury, resulting in enhanced liver fibrosis. Mice overexpressing human FcRIIA in CD11b+ cells show enhanced LAP in response to chronic liver injury, and are protected against inflammation and liver fibrosis. Finally, endogenous activation of LAP is lost in monocytes from severe cirrhotic patients with massive systemic inflammation, and restored upon exposure to intravenous monomeric Immunoglobulin (IVIg). These data shed light on a novel role for LAP in the protection against inflammation during cirrhosis and its progression to severe stages and thus suggest that agents capable of inducing LAP are suitable for treating sustained inflammation in patients suffering from chronic liver disease

Publications:
Autophagy . 2020 Aug;16(8):1526-1528. doi: 10.1080/15548627.2020.1770979. Epub 2020 May 31.

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