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Gut. 2020 Jan 28. pii: gutjnl-2019-319091. doi: 10.1136/gutjnl-2019-319091. [Epub ahead of print]

TGF-β2 silencing to target biliary-derived liver diseases.

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Molecular Hepatology-Alcohol Associated Diseases, Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Molecular Hepatology-Alcohol Associated Diseases, Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
Department of Pharmacology and Toxicology, Faculty of Pharmacy, Tanta University, Tanta, Egypt.
Department of Forensic Medicine and Toxicology, Faculty of Veterinary Medicine, South Valley University, Qena, Egypt.
Institute of Pharmacy and Molecular Biotechnology, Heidelberg University, Heidelberg, Germany.
Isarna Therapeutics GmbH, Munchen, Germany.
Hepatology and Clinical Bioinformatics, Department of Medicine II, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
Research Center for Immunotherapy, University Medical Center, Johannes Gutenberg University, Mainz, Germany.
Institute of Translational Immunology, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany.
Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Department of Immunobiochemistry, Centre for Biomedicine and Medical Technology (CBTM) and European Center for Angioscience (ECAS), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Institute for Clinical Chemistry, Medical Faculty Mannheim of the University of Heidelberg, University Hospital Mannheim, Mannheim, Germany.
Medizinische Klinik 1, Klinikum der Goethe-Universität, Frankfurt am Main, Germany.
Institute of Pathology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Gut Microbes and Health Institute Strategic Programme, Quadram Institute, Norwich, UK.
CIC bioGUNE, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Derio, Spain.
Department of Medical Biology, Pomeranian Medical University, Szczecin, Poland.
Liver and Internal Medicine Unit, Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Warsaw, Poland.
NIHR Applied Immunobiology and Transplant Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK.
Department of Pediatrics and Juvenile Medicine, Center for Liver Cell Research, University of Regensburg Hospital, Regensburg, Germany.
Department of Molecular and Cell Biology, Dr Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany.
Eberhard-Karls-University Tübingen, Tübingen, Germany.
Department of Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.



TGF-β2 (TGF-β, transforming growth factor beta), the less-investigated sibling of TGF-β1, is deregulated in rodent and human liver diseases. Former data from bile duct ligated and MDR2 knockout (KO) mouse models for human cholestatic liver disease suggested an involvement of TGF-β2 in biliary-derived liver diseases.


As we also found upregulated TGFB2 in liver tissue of patients with primary sclerosing cholangitis (PSC) and primary biliary cholangitis (PBC), we now fathomed the positive prospects of targeting TGF-β2 in early stage biliary liver disease using the MDR2-KO mice. Specifically, the influence of TgfB2 silencing on the fibrotic and inflammatory niche was analysed on molecular, cellular and tissue levels.


TgfB2-induced expression of fibrotic genes in cholangiocytes and hepatic stellate cellswas detected. TgfB2 expression in MDR2-KO mice was blunted using TgfB2-directed antisense oligonucleotides (AON). Upon AON treatment, reduced collagen deposition, hydroxyproline content and αSMA expression as well as induced PparG expression reflected a significant reduction of fibrogenesis without adverse effects on healthy livers. Expression analyses of fibrotic and inflammatory genes revealed AON-specific regulatory effects on Ccl3, Ccl4, Ccl5, Mki67 and Notch3 expression. Further, AON treatment of MDR2-KO mice increased tissue infiltration by F4/80-positive cells including eosinophils, whereas the number of CD45-positive inflammatory cells decreased. In line, TGFB2 and CD45 expression correlated positively in PSC/PBC patients and localised in similar areas of the diseased liver tissue.


Taken together, our data suggest a new mechanistic explanation for amelioration of fibrogenesis by TGF-β2 silencing and provide a direct rationale for TGF-β2-directed drug development.


TGF-beta; cholestasis; fibrosis; primary biliary cirrhosis; primary sclerosing cholangitis

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Conflict of interest statement

Competing interests: Isarna Therapeutics GmbH supported this study financially. The company develops TGF-β isoform specific antisense oligonucleotides for therapeutic approaches. However, the company did not influence experimental design and data interpretation. KW, HK and MJ were employed by Isarna Therapeutics at the time of contribution. The position of AD was funded by Isarna Therapeutics.

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