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Hepatocellular carcinoma chemoprevention by targeting the angiotensin-converting enzyme and EGFR transactivation
Emilie Crouchet, Shen Li, Mozhdeh Sojoodi, Simonetta Bandiera, Naoto Fujiwara, Hussein El Saghire, Shijia Zhu, Tongqi Qian, Fahmida Akter Rasha, Fabio Del Zompo, Stephen C. Barrett, Eugénie Schaeffer, Marine A. Oudot, Clara Ponsolles, Sarah C. Durand, Sarani Ghoshal, Gunisha Arora, Fabio Giannone, Raymond T. Chung, Nevena Slovic, Nicolaas Van Renne, Emanuele Felli, Patrick Pessaux, Joachim Lupberger, Nathalie Pochet, Catherine Schuster, Kenneth K. Tanabe, Yujin Hoshida, Bryan C. Fuchs, Thomas F. Baumert
Emilie Crouchet, Shen Li, Mozhdeh Sojoodi, Simonetta Bandiera, Naoto Fujiwara, Hussein El Saghire, Shijia Zhu, Tongqi Qian, Fahmida Akter Rasha, Fabio Del Zompo, Stephen C. Barrett, Eugénie Schaeffer, Marine A. Oudot, Clara Ponsolles, Sarah C. Durand, Sarani Ghoshal, Gunisha Arora, Fabio Giannone, Raymond T. Chung, Nevena Slovic, Nicolaas Van Renne, Emanuele Felli, Patrick Pessaux, Joachim Lupberger, Nathalie Pochet, Catherine Schuster, Kenneth K. Tanabe, Yujin Hoshida, Bryan C. Fuchs, Thomas F. Baumert
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Research Article Hepatology

Hepatocellular carcinoma chemoprevention by targeting the angiotensin-converting enzyme and EGFR transactivation

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Abstract

Hepatocellular carcinoma (HCC) is a leading cause of death among cirrhotic patients, for which chemopreventive strategies are lacking. Recently, we developed a simple human cell-based system modeling a clinical prognostic liver signature (PLS) predicting liver disease progression and HCC risk. In a previous study, we applied our cell-based system for drug discovery and identified captopril, an approved angiotensin converting enzyme (ACE) inhibitor, as a candidate compound for HCC chemoprevention. Here, we explored ACE as a therapeutic target for HCC chemoprevention. Captopril reduced liver fibrosis and effectively prevented liver disease progression toward HCC development in a diethylnitrosamine (DEN) rat cirrhosis model and a diet-based rat model for nonalcoholic steatohepatitis–induced (NASH-induced) hepatocarcinogenesis. RNA-Seq analysis of cirrhotic rat liver tissues uncovered that captopril suppressed the expression of pathways mediating fibrogenesis, inflammation, and carcinogenesis, including epidermal growth factor receptor (EGFR) signaling. Mechanistic data in liver disease models uncovered a cross-activation of the EGFR pathway by angiotensin. Corroborating the clinical translatability of the approach, captopril significantly reversed the HCC high-risk status of the PLS in liver tissues of patients with advanced fibrosis. Captopril effectively prevents fibrotic liver disease progression toward HCC development in preclinical models and is a generic and safe candidate drug for HCC chemoprevention.

Authors

Emilie Crouchet, Shen Li, Mozhdeh Sojoodi, Simonetta Bandiera, Naoto Fujiwara, Hussein El Saghire, Shijia Zhu, Tongqi Qian, Fahmida Akter Rasha, Fabio Del Zompo, Stephen C. Barrett, Eugénie Schaeffer, Marine A. Oudot, Clara Ponsolles, Sarah C. Durand, Sarani Ghoshal, Gunisha Arora, Fabio Giannone, Raymond T. Chung, Nevena Slovic, Nicolaas Van Renne, Emanuele Felli, Patrick Pessaux, Joachim Lupberger, Nathalie Pochet, Catherine Schuster, Kenneth K. Tanabe, Yujin Hoshida, Bryan C. Fuchs, Thomas F. Baumert

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Figure 7

Validation of the potential therapeutic effect of captopril in patient-derived liver tissues.

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Validation of the potential therapeutic effect of captopril in patient-d...
(A) Enrichment of RAS-related signatures in NAFLD/NASH cohorts (GSEI). Jonckheere-Terpstra test was used to test gradual increase of continuous values along with ordinal variables (NASH stage). Exact P values are shown. GSE48452: healthy obesity, n = 27; NASH, n = 18. (B and C) ACE and AGTR1 expression in liver tissues of clinical cohorts with chronic liver disease and HCC. GSE20140: hepatitis/cirrhosis, n = 307; HCC, n = 80. Exact P values are shown (Mann-Whitney U test). GSE94660: paired samples, n = 21. Exact P values are shown (paired t test). (D) Captopril reverts the FFA-induced poor-prognosis PLS in culture of patient-derived multicellular spheroids (2 patients without history of chronic liver disease). PLS induction was determined by GSEA using “Mock” nontreated spheroids as reference, and PLS reversion was determined by comparing FFA + captopril–treated spheroids to FFA-treated spheroids. (E) Captopril reverts the PLS poor-prognosis status in human liver fibrotic tissue precision-cut slices that were surgically resected from fibrotic patients diagnosed with alcoholic liver disease. Erlotinib was used as positive control. PLS reversal was determined by GSEA using vehicle-treated tissues as reference. Simplified heatmaps show (top) the classification of PLS status as poor (orange) or good (green) prognosis, and (bottom) the significance of induction (red) or suppression (blue) of poor- or good-prognosis genes. (F) Captopril decreases cell viability in a 3D patient-derived tumorspheroid model. HCC spheroids were generated from patient tumor tissues from different etiologies. Cell viability was assessed 3 days after treatment by measuring ATP levels. Each experiment shows mean ± SD in percentage compared with DMSO. For patient information, refer to Supplemental Table 4. Schemes of D–F were created with BioRender.com.

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