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Définir de nouvelles cibles thérapeutiques pour l´hépatite alcoolique : nécessité d´une approche translationnelle

Abstract : Alcoholic hepatitis (AH) is a complex disease associated to a poor prognosis. The therapeutic arsenal is limited to corticosteroid treatment. However, 40% of patients do not respond to the treatment and liver transplantation represents the last option for their survival. AH is characterized by a large infiltration of polymorphonuclear neutrophils (PMN), and paradoxically the infection of these patients is a frequent event related to mortality. On the other hand, our group has demonstrated in AH an important defect of hepatic regeneration characterized by a decrease in hepatocytes proliferation, and the formation of ductular reaction. The aim of our study was to determine the cellular mechanisms causing the defect of liver regeneration in AH, to explore the pathophysiological mechanisms involved in the interaction of the PMN and hepatocytes, and to evaluate the migratory capacity of the PMN.Our work has highlighted the Hippo/YAP pathway as profoundly altered during AH. The effector YAP was aberrantly activated in AH hepatocytes. This led to the dedifferentiation and the loss of function of hepatocytes. The treatment of AH-isolated hepatocytes by the YAP inhibitor, dobutamine, limited the dedifferentiation process. Targeting YAP appears as an innovative strategy for AH management. Our work also identified the NOD1 pathway as a major actor in the PNN/hepatocyte interaction through expression of adhesion molecules. Our results suggest that NOD1 is an interesting target to limit PMN-induced liver injury. In addition, during AH, deregulation of the IL33 / sST2 pathway was involved in PNN migration. We have demonstrated a decrease in the migratory capacity of circulating PMNs. The treatment of PMN by IL33 was able to compensate for this migratory defect, which represents an interesting tool to prevent infectious risks during AH.
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Mohamed Bousaleh. Définir de nouvelles cibles thérapeutiques pour l´hépatite alcoolique : nécessité d´une approche translationnelle. Médecine humaine et pathologie. Université du Droit et de la Santé - Lille II, 2019. Français. ⟨NNT : 2019LIL2S041⟩. ⟨tel-02922838⟩

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