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CCL24 regulates biliary inflammation and fibrosis in primary sclerosing cholangitis
Raanan Greenman, Michal Segal-Salto, Neta Barashi, Ophir Hay, Avi Katav, Omer Levi, Ilan Vaknin, Revital Aricha, Sarit Aharoni, Tom Snir, Inbal Mishalian, Devorah Olam, Johnny Amer, Ahmad Salhab, Rifaat Safadi, Yaakov Maor, Palak Trivedi, Christopher J. Weston, Francesca Saffioti, Andrew Hall, Massimo Pinzani, Douglas Thorburn, Amnon Peled, Adi Mor
Raanan Greenman, Michal Segal-Salto, Neta Barashi, Ophir Hay, Avi Katav, Omer Levi, Ilan Vaknin, Revital Aricha, Sarit Aharoni, Tom Snir, Inbal Mishalian, Devorah Olam, Johnny Amer, Ahmad Salhab, Rifaat Safadi, Yaakov Maor, Palak Trivedi, Christopher J. Weston, Francesca Saffioti, Andrew Hall, Massimo Pinzani, Douglas Thorburn, Amnon Peled, Adi Mor
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Research Article Hepatology Inflammation

CCL24 regulates biliary inflammation and fibrosis in primary sclerosing cholangitis

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Abstract

ˆCCL24 is a pro-fibrotic, pro-inflammatory chemokine expressed in several chronic fibrotic diseases. In the liver, CCL24 plays a role in fibrosis and inflammation, and blocking CCL24 led to reduced liver injury in experimental models. We studied the role of CCL24 in primary sclerosing cholangitis (PSC) and evaluated the potential therapeutic effect of blocking CCL24 in this disease. Multidrug resistance gene 2–knockout (Mdr2–/–) mice demonstrated CCL24 expression in liver macrophages and were used as a relevant experimental PSC model. CCL24-neutralizing monoclonal antibody, CM-101, significantly improved inflammation, fibrosis, and cholestasis-related markers in the biliary area. Moreover, using spatial transcriptomics, we observed reduced proliferation and senescence of cholangiocytes following CCL24 neutralization. Next, we demonstrated that CCL24 expression was elevated under pro-fibrotic conditions in primary human cholangiocytes and macrophages, and it induced proliferation of primary human hepatic stellate cells and cholangiocytes, which was attenuated following CCL24 inhibition. Correspondingly, CCL24 was found to be highly expressed in liver biopsies of patients with PSC. CCL24 serum levels correlated with Enhanced Liver Fibrosis score, most notably in patients with high alkaline phosphatase levels. These results suggest that blocking CCL24 may have a therapeutic effect in patients with PSC by reducing liver inflammation, fibrosis, and cholestasis.

Authors

Raanan Greenman, Michal Segal-Salto, Neta Barashi, Ophir Hay, Avi Katav, Omer Levi, Ilan Vaknin, Revital Aricha, Sarit Aharoni, Tom Snir, Inbal Mishalian, Devorah Olam, Johnny Amer, Ahmad Salhab, Rifaat Safadi, Yaakov Maor, Palak Trivedi, Christopher J. Weston, Francesca Saffioti, Andrew Hall, Massimo Pinzani, Douglas Thorburn, Amnon Peled, Adi Mor

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Figure 1

scRNA-Seq of monocytes and macrophages from 3-month-old Mdr2–/– mice.

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scRNA-Seq of monocytes and macrophages from 3-month-old Mdr2–/– mice.
(A...
(A) Five populations of monocytes/macrophages and dendritic cells (DCs) were identified using general mononuclear phagocyte markers: Cd86, Aif1 (Iba1), Cd68, and Adgre1 (F4/80). (B) Heatmap, mononuclear phagocyte cluster marker genes (left, color coded by cluster), exemplar genes labeled (bottom). Genes columns, clusters rows. (C–H) Each population was characterized using specific genes. Res Mac express Cd163, Marco, and Clec4f (C). Mo/Mac identified by Cx3cr1, H2-M2, and Ccl8 (Mcp2) (D). Mo were characterized by Chil3, Inhba, and Areg expression (E). DCs were characterized by Clec9a, Cd209a (DC-SIGN), and Ccr7 (F). (G) Ccl24’s robust expression by liver-resident macrophages. (H) A potentially unique subpopulation of macrophages express Ccl24 as well as endothelial cell gene markers like Lyve1. (I) Secreted levels of CCL24 from isolated mouse Kupffer cells that were cultured with or without IL-4 supplement (20 ng/mL). Data are shown as mean ± SEM (n = 3). *P ≤ 0.05, t test. Res Mac, resident macrophages; Mo, monocytes; Mo/Mac, monocyte-derived macrophages; Lyve1, lymphatic vessel endothelial hyaluronan receptor 1.

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