Document #77 Medical Affairs

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Routing confidence: 90% • Candidates: Medical Affairs, R&D, Commercial

Routing reasons: ML fallback: low confidence (57% < 57%); The document discusses new scientific insights related to macrophages' role in metabolic dysfunction-associated steatohepatitis (MASH) and liver fibrosis, which are relevant to understanding disease pathology and treatment.; It includes detailed findings from a recent research paper involving macrophage subpopulations and therapeutic targets like TREM2, which are of interest primarily to medically trained professionals and scientific communicators.; The discussion of clinical relevance, potential drug targets, and epidemiological data suggests the content is aimed at medical affairs professionals who bridge scientific research and clinical application.; The document mentions several academic and medical research institutions, NIH grants, and clinical implications, reinforcing the medical affairs focus rather than purely commercial or early research.

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New insights into macrophages' role in MASH and liver fibrosis Skip to content Menu Medical Home Life Sciences Home Become a Member Search Medical Home Life Sciences Home About Functional Food News Health A-Z Drugs Medical Devices Interviews White Papers More... MediKnowledge eBooks Posters Podcasts Newsletters Health & Personal Care Contact Meet the Team Advertise Search Become a Member Top Health Categories Coronavirus Disease COVID-19 Diet & Nutrition Artificial Intelligence Allergies Alzheimer's & Dementia Arthritis & Rheumatology Breast Cancer Breastfeeding Cold, Flu & Cough Dermatology Diabetes Eating Disorders Eye Health Gastrointestinal Health Heart Disease Lung Cancer Mental Health Parkinson's Disease Pregnancy Sleep Urology View Health A-Z × Top Health Categories Coronavirus Disease COVID-19 Eating Disorders Diet & Nutrition Eye Health Artificial Intelligence Gastrointestinal Health Allergies Heart Disease Alzheimer's & Dementia Lung Cancer Arthritis & Rheumatology Mental Health Breast Cancer Parkinson's Disease Breastfeeding Pregnancy Cold, Flu & Cough Sleep Dermatology Urology Diabetes View Health A-Z Medical Home Life Sciences Home About News Life Sciences A-Z White Papers Lab Equipment Interviews Newsletters Webinars More... eBooks Posters Podcasts Contact Meet the Team Advertise Search Become a Member White Papers MediKnowledge eBooks Posters Podcasts Newsletters Health & Personal Care Contact Meet the Team Advertise Search Become a Member Webinars eBooks Posters Podcasts Contact Meet the Team Advertise Search Become a Member New insights into macrophages' role in MASH and liver fibrosis Download PDF Copy Reviewed Sanford Burnham Prebys Aug 22 2024 Formerly known as nonalcoholic steatohepatitis, metabolic dysfunction-associated steatohepatitis (MASH) is an inflammatory disease characterized by liver scarring or fibrosis that progressively impairs liver function. It is a major risk factor for cirrhosis and liver cancer. And because treatment options are limited, MASH is the second leading cause for liver transplants in the United States after cirrhosis caused by chronic hepatitis C infection. A better understanding of the pathological processes that drive MASH is critical to creating effective treatments. In a new paper published August 19, 2024 in PNAS, a team of scientists from Sanford Burnham Prebys, the University of California San Diego School of Medicine and elsewhere, describe the complex interplay between diseased liver cells and macrophages - a type of white blood cell whose jobs include killing and removing harmful cells and pathogens and helping to spur normal healing. Debanjan Dhar, PhD, associate professor in the Cancer Genome and Epigenetics Program at Sanford Burnham Prebys, is senior author of the study. David Brenner, MD, president and CEO of Sanford Burnham Prebys, and Christopher Glass, MD, PhD, professor of cellular and molecular medicine at UC San Diego, are corresponding authors. Souradipta Ganguly, PhD, a postdoctoral research fellow at UC San Diego and Sanford Burnham Prebys, is first author. The researchers found that the heterogeneous mix of macrophages involved with MASH was different, depending on whether the disease was progressing or regressing. More importantly, they identified specific macrophage subpopulations that are critical for resolving MASH and liver fibrosis in which accumulating scar tissue impairs the organ's ability to function or repair itself. These fibrotic bands restrict blood flow, imperiling the entire organ. "In MASH, Kupffer cells (a type of macrophage that resides in the liver) are lost and replaced by four distinct macrophage subpopulations. When the disease is in regression - that is, symptoms or severity are decreasing - two lipid associated macrophage subpopulations are dominant and express TREM2, a cell receptor that regulates cell survival, proliferation and anti-inflammatory responses," said Brenner. "MASH regression occurs in the presence if TREM2+ macrophages. They not only restrict the progression of MASH-fibrosis, but effectively slow it and reduce inflammation . The absence of TREM2+ macrophages allows the disease to progress." In early and moderate stages, MASH often produces no tell-tale symptoms, which is part of the why it has reached epidemic proportions in the U.S. The American Liver Foundation estimates 80 to 100 million Americans have fatty liver disease which, undiagnosed and untreated, progresses to nonalcoholic steatohepatitis, MASH, cirrhosis, liver cancer and death, often in combination with other conditions, such as obesity. An estimated 1.5% to 6.5% of U.S. adults have MASH. afflicted by the condition, and roughly 24% of adults have metabolic dysfunction-associated steatotic fatty liver disease, the starting point for MASH, cirrhosis and worse. Our findings suggest that lipid associated macrophages that express TREM2 and TREM2 are required both for the emergence of more liquid associated macrophages and for their reparative functions." Debanjan Dhar, PhD, associate professor in the Cancer Genome and Epigenetics Program, Burnham Prebys Related Stories Cornell study finds existing drug could boost liver cancer immunotherapy Diagnostic prognostic and therapeutic relevance of PIVKA-II in hepatocellular carcinoma Researchers develop new score to predict the risk of liver cancer "Effective degradation of scar tissue as a protective mechanism is mediated by TREM2, and the absence of TREM2+ macrophages not only disrupts the liver's ability to remove fibrotic tissue, but it also harms the entire immune response and healing process." Going forward, the scientists say a TREM2 agonist - a drug or substance that mimics the function of TREM2 - might be beneficial for MASH/fibrosis therapy and help spur MASH and fibrosis regression in patients also undergoing lifestyle modification, weight loss or bariatric surgery. "There is only one approved treatment for MASH, and it was only approved earlier this year," said Glass. "Any opportunities to expand clinical options that benefit patients need to be thoroughly pursued because liver disease in this country - and around the world - is only getting worse." Additional authors on the study include Sara Brin Rosenthal, Kei Ishizuka, Theresa V. Rohm, Naser Khader, Sebastiano Archilei, Jerrold M. Olefsky, Ariel E. Feldstein, Tatiana Kisseleva and Rohit Loomba, all at UC San Diego; Ty D. Troutman, UC San Diego and Cincinnati Children's Hospital Medical Center, and German Aleman Muench, Yasuyo Sano and Pejman Soroosh, Janssen Research & Development, San Diego. This study was supported by National Institutes of Health grants to D.D. (R01DK137061, R01DK133930), Altman Clinical and Translational Research Institute (ACTRI – KL2TR001444) and the San Diego Digestive Diseases Research Center (NIH DK120515). It was partially supported by the ACTRI (NIH UL1TR001442). T.K. was supported by NIH grants DK099205, AA028550, DK101737, AA011999, DK120515, AA029019, DK091183; C.K.G by NIH grants DK091183 and HL147835. T.D.T. was supported by NIH grants P30DK063491, T32DK007044, P30DK078392, the American Association for the Study of Liver Diseases (PNC23-216751) and the Center for Inflammation and Tolerance through the Cincinnati Children's Research Foundation. R.L. received funding support from NCATS (5UL1TR001442), NIDDK (U01DK061734, U01DK130190, R01DK106419, R01DK121378, R01DK124318, P30DK120515), NHLBI (P01HL147835), the John C. Martin Foundation (RP124). J.M.O was supported by the Diabetes Research Center (P30DK063491) and Horton JPI MRA: Obesity and its metabolic complications (20175015). A.E.F was supported by the NIH grant R01DK113592. T.V.R was supported by grants from the Swiss National Science Foundation (P2BSP3_200177) and the Larry L. Hillblom Foundation (2023-D-012-FEL). Source: Sanford Burnham Prebys Journal reference: Ganguly, S., et al. (2024) Lipid-associated macrophages’ promotion of fibrosis resolution during MASH regression requires TREM2 . PNAS . doi.org/10.1073/pnas.2405746121 . Posted in: Medical Science News | Medical Research News | Medical Condition News Comments (0) Download PDF Copy Suggested Reading Liver-derived protein supports bone health in males Engineered liver tissue model mimics early metabolic liver disease Myosteatosis: An emerging predictor of outcomes in chronic liver disease Bacterial infections in patients with liver cirrhosis show rising prevalence and high mortality Study explores whether a bidirectional causal link exists between MASLD and sarcopenia A dual-action approach to preventing hepatocellular carcinoma MET signaling plays a critical protective role in acetaminophen-induced acute liver failure Do cocoa flavanols influence heart and fatty liver risk factors? 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One-line Summary

TREM2-expressing lipid-associated macrophages are critical for resolving MASH and liver fibrosis by promoting scar tissue degradation and anti-inflammatory responses.

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Expected: 3–5 bullets.

Mind Map

mindmap
  root((MASH and Liver Fibrosis))
    Macrophages
      Kupffer Cells
      Replacement Subpopulations
        Lipid-associated Macrophages
          TREM2+ Macrophages
            Role in Regression
              Scar Degradation
              Anti-inflammatory
            Role in Progression
              Absent TREM2+ leads to fibrosis
    Disease Phases
      Progression
      Regression
    Therapeutic Potential
      TREM2 Agonists
        Potential Benefits
          Fibrosis Resolution
          Immune Modulation
        Risks
          Off-target Effects
          Patient Variability
    Experimental Approaches
      In vivo Models
      TREM2 Knockouts
      Pharmacologic Intervention
      Human Biopsy Analysis

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Domain: Clinical & Medical Strategy

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Citations: 3

Evidence Gaps: Clinical efficacy and safety of TREM2 agonists remain to be established; human translational studies are needed.

Astaxanthin and Human Health: Evidence on Skin, Vision, Brain, and Aging The Gut–Brain–Skin Axis: How Diet and Gut Health Influence Mood, Skin, and Aging How Morning Routines Influence Cognitive Performance, Mood, and Circadian Rhythm Camel Milk Nutrition Facts and Potential Health Benefits Explained Edible Insects as

… Rosanna Zhang from ACROBiosystems about utilizing organoids for disease modeling in the field of neuroscience research. Astaxanthin and Human Health: Evidence on Skin, Vision, Brain, and Aging The Gut–Brain–Skin Axis: How Diet and Gut Health Influence Mood, Skin, and Aging How Morning Routines Influence Cognitive Performance, Mood, and Circadian Rhythm Camel Milk Nutrition Facts and Potential Health Benefits Explained Edible Insects as Food: Nutritional Benefits, Safety, and Environmental Impact Latest News Researchers discover a way to breach cancer’s …

Medical Insights: Targeting specific macrophage subpopulations may enhance anti-fibrotic therapies in MASH beyond lifestyle interventions.

More importantly, they identified specific macrophage subpopulations that are critical for resolving MASH and liver fibrosis in which accumulating scar tissue impairs the organ's ability to function or repair itself.

…ous mix of macrophages involved with MASH was different, depending on whether the disease was progressing or regressing. More importantly, they identified specific macrophage subpopulations that are critical for resolving MASH and liver fibrosis in which accumulating scar tissue impairs the organ's ability to function or repair itself . These fibrotic bands restrict blood flow, imperiling the entire organ. "In MASH, Kupffer cells (a type of macrophage t…

Scientific Summary: Identification of TREM2+ macrophage subsets as key drivers of fibrosis resolution informs understanding of MASH pathology.

(2024) Lipid-associated macrophages’ promotion of fibrosis resolution during MASH regression requires TREM2 .

…the Larry L. Hillblom Foundation (2023-D-012-FEL). Source: Sanford Burnham Prebys Journal reference: Ganguly, S., et al. (2024) Lipid-associated macrophages’ promotion of fibrosis resolution during MASH regression requires TREM2 . PNAS . doi.org/10.1073/pnas.2405746121 . Posted in: Medical Science News | Medical Research News | Medical Condition N…

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