Lysyl oxidase-like protein 2 (LOXL2) modulates barrier function in cholangiocytes in cholestasis.

BACKGROUND & AIMS: The lysyl oxidase-like protein 2 (LOXL2) promotes stabilization of the extracellular matrix, chemotaxis, cell growth and cell mobility. We aimed to (i) identify stimuli of LOXL2 in cholangiopathies, (ii) characterize the effects of LOXL2 on biliary epithelial cells' (BECs) barrier function, (iii) compare LOXL2 expression in primary sclerosing cholangitis (PSC), primary biliary cholangitis, and disease controls, and (iv) to determine LOXL2 expression and its cellular sources in four mouse models of cholangiopathies. METHODS: Cultured murine BECs were challenged with well-known triggers of cellular senescence, hypoxia, phospholipid-deficient Abcb4-/- mouse bile and chenodeoxycholic acid and investigated for LOXL2, SNAIL1 and E-cadherin expression and transepithelial electrical resistance with and without LOX-inhibition. In vivo, LOXL2 expression was studied in PSC livers, and controls and mouse models. We compared LOXL2 serum levels in patients with PSC, secondary SC, primary biliary cholangitis, and controls. RESULTS: Cellular senescence, hypoxia, Abcb4-/- bile and chenodeoxycholic acid induced LOXL2 and SNAIL1 expression, repressed E-cadherin expression, and significantly reduced transepithelial electrical resistance in BECs. Notably, all of the pathological changes could be recovered via pharmacological LOX-inhibition. Mouse models showed induced LOXL2 expression in the portal region and in association with ductular reaction. LOXL2 serum levels were significantly elevated in patients with cholangiopathies. In PSC, LOXL2 expression was located to characteristic periductal onion skin-type fibrosis, ductular reaction, Kupffer cells, and fibrotic septa. Importantly, in PSC, LOXL2 overexpression was paralleled by E-cadherin loss in BECs from medium-sized bile ducts. CONCLUSIONS: Reactive BECs produce LOXL2, resulting in increased tight junction permeability, which can be ameliorated by pharmacological LOX-inhibition in vitro. Reactive BECs, portal myofibroblasts, and Kupffer cells are the main sources of LOXL2 in cholangiopathies. LAY SUMMARY: In this study, we investigate the role of lysyl oxidase-like protein 2 (LOXL2), an enzyme pivotal in the development of organ fibrosis, in the pathogenesis of cholangiopathies (diseases of bile ducts), such as primary sclerosing cholangitis. We found LOXL2 to be expressed in association with bile duct epithelial injury and uncovered mechanisms for its upregulation and the subsequent effects in vitro and in vivo. Our findings support testing of anti-LOXL2 treatment strategies for patients with primary sclerosing cholangitis.

Liver fibrosis progression at autopsy in injecting drug users infected by hepatitis C: a longitudinal long-term cohort study.

BACKGROUND & AIMS: There is a paucity of unbiased data on the natural history of hepatitis C virus (HCV) infection in injecting drug users (IDUs). The purpose of this study was to assess the risk of developing advanced fibrosis associated with chronic hepatitis C (CHC) infection among injecting drug users (IDUs) who underwent an autopsy. METHODS: A longitudinal cohort design was applied, in which the stage of liver fibrosis in anti-HCV positive IDUs with or without chronic HCV infection was assessed in liver tissue from autopsies performed up to 35 years after HCV exposure. The cohort originated from 864 IDUs consecutively admitted for drug abuse treatment 1970-1984. Stored sera, mostly drawn at the time of admission for drug treatment, were available in 635 subjects. 220 out of 523 anti-HCV positive subjects had died before 2009. Liver tissue from autopsies was available from 102/220 subjects, of which 61 were HCV RNA positive. Liver sections were classified according to METAVIR scores for fibrosis. Two pathologists, both blinded for serologic results, scored sections of liver tissue. RESULTS: Among HCV RNA positive subjects 16.4% (10/61) had septal fibrosis (F3) or cirrhosis (F4) compared to 2.4% (1/41) among anti HCV positive/HCV RNA negative subjects (p=0.026). Of 18 HCV RNA positive subjects autopsied <15 years after HCV exposure none had F3 or F4. Among subjects autopsied >25 years after exposure 35% (6/17) had F3-F4. CONCLUSIONS: Among IDUs chronically infected by HCV, 1/3 developed septal fibrosis or cirrhosis 25 years or more after exposure.

Effect of vaccination with mutant KRAS peptides on rat colon carcinogenesis induced by azoxymethane.

Rat colon carcinogenesis induced by 2 x 15 mg/kg body weight of azoxymethane (AOM) is a standard model, widely used to evaluate the role of nutritional components and chemopreventive agents at various stages of tumorigenesis. In this model, KRAS mutations have been frequently observed in aberrant crypt foci (ACF), putative preneoplastic lesions, as well as in tumours. Therefore we used this model and vaccinated F344 rats with a mixture of synthetic mutant KRAS peptides (MT KRAS) corresponding to frequent KRAS exon 1 mutations before AOM treatment in order to study the role of KRAS mutations in the development of ACF and subsequently tumours. The controls were sham-vaccinated with KRAS exon 1 wild-type KRAS peptides (WT KRAS). MT KRAS vaccination suppressed the number of ACF by 42% at week 13 (p=0.001). The subpopulation of ACF suppressed by MT KRAS vaccination had higher focal crypt multiplicity than the control ACF population (p=0.001). At week 26, vaccination reduced the KRAS mutation frequency in ACF from 50% in the MT KRAS group to 13% in the WT KRAS (p=0.038). However, at this phase of carcinogenesis, vaccination did not have significant effects on the ACF number and focal crypt multiplicity. Surprisingly, the KRAS mutation frequency was only 5% in the colonic tumours of the controls (1 out of 20 tumours). Although there were no tumours with KRAS mutations in the MT KRAS group, the possible effect of vaccination could not be evaluated. These data indicate that KRAS mutations play a minor role in colonic tumorigenesis and that ACF with KRAS mutations could hardly be the precursors of the AOM-induced tumours in rats. Hence, the cancer protective potential of a KRAS vaccine in the early phase of AOM-induced colon carcinogenesis in the rat appeared minuscule. Additional studies in a model with a high outcome of KRAS mutations in colonic tumours are needed to evaluate the effects of a KRAS vaccine at later stages of tumorigenesis.

Age-dependent susceptibility to azoxymethane-induced and spontaneous tumorigenesis in the Min/+ mouse.

We examined the age-dependent susceptibility to azoxymethane (AOM)-induced and spontaneous tumorigenesis in the Min/+ mouse, a murine FAP model. The colon carcinogen AOM was given to pups (weeks 1 and 2) and young adults (weeks 4 and 5). In the colon, AOM exposure of pups and young adults caused a 17-fold and 10-fold increase (p < 0.001) in the number of dysplastic aberrant crypt foci (ACF) compared with vehicle-treated controls, respectively; the pups were 1.7 times mores susceptible than young adults (p = 0.002). AOM-specific dysplastic ACF grew significantly faster (p < 0.001) in pups than in young adults. In the small intestine of AOM-exposed pups, the number of adenomas was increased 1.5-fold compared with controls (p < 0.001), while a similar exposure of young adults did not affect the tumorigenesis. Dysplastic ACF in the colon were morphologically equivalent with nascent adenomas in the small intestine. When comparing the size distributions of AOM-specific and spontaneous lesions the majority of the spontaneous lesions was apparently initiated before week 2. In conclusion, pups were more susceptible than young adults to AOM-induced and spontaneous tumorigenesis, and neonatal exposure was not as critical for AOM-induced tumorigenesis in the colon as in the small intestine.