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La consommation excessive d’alcool est la première cause de cirrhose en France. L’atteinte hépatique débute par une stéatose (accumulation de triglycérides dans les hépatocytes) qui peut évoluer vers un état inflammatoire (hépatite alcoolique) lors d’une consommation chronique d’alcool. La maladie peut ensuite évoluer vers la fibrose, la cirrhose et jusqu'à l’hépatocarcinome. La mortalité des formes aiguës de l’hépatite alcoolique sévère est comprise entre 50 et 75%. La corticothérapie est le seul traitement qui peut améliorer le pronostic à court terme. D’autres facteurs que la seule consommation excessive d’alcool interviennent dans la genèse des lésions hépatiques. Ainsi, parmi les sujets ayant une forte consommation d’alcool à long terme, la majorité des patients développent une stéatose mais seulement 10 à 35% développeront une hépatite et 8 à 20% évolueront vers la cirrhose. La recherche de facteurs qui relient la consommation d’alcool et la nature et progression des lésions hépatiques est donc essentielle pour trouver de nouvelles cibles thérapeutiques améliorant la prise en charge de ces formes graves. Afin de rechercher quels sont ces facteurs, nous avons utilisé un modèle murin d’alcoolisation. Nous avons utilisé un régime Lieber de Carli (LDC) enrichi en graisses, additionné d’alcool ou non. Nous avons orienté notre projet vers un axe microbiote-inflammation hépatique en analysant l’évolution des populations bactériennes intestinales au cours de la surconsommation d’alcool chez la souris. Des résultats nous ont montré que les Bacteroides variaient grandement d’une animalerie à l’autre. L’objet de nos travaux était d’étudier l’effet de la modulation des Bacteroides sur l’apparition des lésions hépatiques lors de la maladie alcoolique du foie. / Excessive alcohol consumption in the first cause of liver cirrhosis in France. Liver damages begin with steatosis (accumulation of fat in hepatocytes), which can progress to an inflammatory state (alcoholic hepatitis) during a long-term chronic alcohol consumption. Then, the disease can degenerate in liver fibrosis, cirrhosis and reach the hepatocarcinoma state. The mortality rate of acute alcoholic hepatitis ranges from 50% to 75%. Treatment based on corticoids is the only available and efficient treatment to improve the short-term prognosis. Other factors than only excessive alcohol consumption play a role in the onset of hepatic damages. Among patients having a long-term alcohol excessive consumption, most of them will develop a steatosis, whereas only 10% to 35% will develop alcoholic hepatitis and only 8 to 20% a liver cirrhosis. Researching these factors linking alcohol consumption and the nature and onset of liver injuries is of the utmost importance in order to find new therapeutic targets improving the patient life expectancy.In order to research these actors, we used a mice alcoholization model. We used a Lieber DeCarli diet, enriched in fat, added with ethanol or not. We studied the link between intestinal microbiota composition and the onset of liver injuries, by analyzing bacterial populations during an excessive alcohol consumption in mice. We discovered that one of the major bacterial population composing the intestinal microbiota, Bacteroides, underwent differential modifications from one animal housing facility to the other. The aim of our work was to modulate the Bacteroides population and study its effects on liver injuries.

Chronic liver diseases, which includes alcoholic liver disease (ALD), are consistently among the top 15 leading causes of death in the United States. ALD is characterized by progression from a normal liver to fatty liver disease (hepatic steatosis), which can lead to cirrhosis, alcoholic hepatitis, and liver failure. We have identified a novel role of phosphohistidine signaling, mediated through phosphohistidine phosphatase 1 (PHPT1), in the onset of hepatic steatosis. We have identified PHPT1 as a target of selective oxidation following acute ethanol exposure as well as being downregulated following chronic ethanol exposure. We mapped the oxidative modification site and developed a mass-spectrometry based phosphohistidine phosphatase assay to determine the impact of PHPT1 oxidative modification during acute ethanol exposure. To further understand the role of PHPT1 and phosphohistidine signaling during chronic ethanol exposure, we have developed PHPT1 overexpression and knockout mouse models. These mouse models were characterized using mass spectrometry-based proteomics. They were then utilized in a 10-day chronic ethanol plus binge model to determine the impact of PHPT1 expression on the onset of ethanol-induced hepatic steatosis. In addition, advanced mass spectrometry-based phenotypic characterization was performed on the treated liver tissues to determine the key regulators and canonical pathways influencing phosphohistidine signaling during chronic ethanol exposure. We have evidence to suggest that PHPT1 overexpression plays a protective role in the onset of hepatic steatosis, the PHPT1 heterozygous model is more susceptible to liver damage, and the complete knockout model is embryonically lethal. Additionally, we have identified novel pathways and regulators involved in phosphohistidine signaling during the development of ethanol-induced hepatic steatosis.

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Alcoholic steatosis (AS) is the initial pathology associated with early stage alcoholic liver disease and is characterized by the accumulation of fat in the liver. AS is considered clinically benign as it is reversible, as compared with alcoholic steatohepatitis (ASH) which is the next stage of alcoholic liver disease (ALD), and mostly irreversible. Proteomics were used to investigate the molecular basis of AS to determine biomarkers representative of AS. Liver tissue proteins at different stages of steatosis from a rodent model of AS were separated by two dimensional electrophoresis (2DE), followed by MALDI mass spectrometry (MS) identification of significantly expressed proteins. Expression levels of several proteins related to alcohol induced oxidative stress, such as peroxiredoxin 6 (PRDX6) and aldehyde dehydrogenase 2 (ALDH2) were reduced by 2 to 3-fold in ethanol fed rats, and suggested an increase in oxidative stress. Several proteins involved in fatty acid and amino acid metabolism were found at increased expression levels, suggesting higher energy demand upon chronic exposure to ethanol. In order to delineate between the effects of fat accumulation and oxidative stress, an in vitro hepatocyte cell culture model of steatosis was developed. HepG2 cells loaded with oleic acid surprisingly demonstrated lower cytotoxicity upon oxidative challenge (based on lactate dehydrogenase activity) and inflammation (based on TNF-? induced activation of the pro-inflammatory transcription factor NF-?B). We also examined the effect of oleic acid loading in HepG2 cells on protein carbonylation, which is an important irreversible protein modification during oxidative stress that leads to protein dysfunction and disease. Fat-loaded hepatocytes exposed to oxidative stress with tert-butyl hydroperoxide (TBHP) contained 17% less carbonylated proteins than the non-fat loaded control. Mass spectrometric analysis of carbonylated proteins indicated that known classical markers of protein carbonylation (e.g., cytoskeletal proteins, chaperones) are not carbonylated in oleic acid loaded HepG2 cells, and suggests that the protective effect of fat loading is through interference with protein carbonylation. While counterintuitive to the general concept that AS increases oxidative stress, our fat loading results suggests that low levels of fat may activate antioxidant pathways and ameliorate the effect of subsequent oxidative or inflammatory challenge.

Alcoholic steatosis (AS) is the initial pathology associated with early stage alcoholic liver disease and is characterized by the accumulation of fat in the liver. AS is considered clinically benign as it is reversible, as compared with alcoholic steatohepatitis (ASH) which is the next stage of alcoholic liver disease (ALD), and mostly irreversible. Proteomics were used to investigate the molecular basis of AS to determine biomarkers representative of AS. Liver tissue proteins at different stages of steatosis from a rodent model of AS were separated by two dimensional electrophoresis (2DE), followed by MALDI mass spectrometry (MS) identification of significantly expressed proteins. Expression levels of several proteins related to alcohol induced oxidative stress, such as peroxiredoxin 6 (PRDX6) and aldehyde dehydrogenase 2 (ALDH2) were reduced by 2 to 3-fold in ethanol fed rats, and suggested an increase in oxidative stress. Several proteins involved in fatty acid and amino acid metabolism were found at increased expression levels, suggesting higher energy demand upon chronic exposure to ethanol. In order to delineate between the effects of fat accumulation and oxidative stress, an in vitro hepatocyte cell culture model of steatosis was developed. HepG2 cells loaded with oleic acid surprisingly demonstrated lower cytotoxicity upon oxidative challenge (based on lactate dehydrogenase activity) and inflammation (based on TNF-? induced activation of the pro-inflammatory transcription factor NF-?B). We also examined the effect of oleic acid loading in HepG2 cells on protein carbonylation, which is an important irreversible protein modification during oxidative stress that leads to protein dysfunction and disease. Fat-loaded hepatocytes exposed to oxidative stress with tert-butyl hydroperoxide (TBHP) contained 17% less carbonylated proteins than the non-fat loaded control. Mass spectrometric analysis of carbonylated proteins indicated that known classical markers of protein carbonylation (e.g., cytoskeletal proteins, chaperones) are not carbonylated in oleic acid loaded HepG2 cells, and suggests that the protective effect of fat loading is through interference with protein carbonylation. While counterintuitive to the general concept that AS increases oxidative stress, our fat loading results suggests that low levels of fat may activate antioxidant pathways and ameliorate the effect of subsequent oxidative or inflammatory challenge.

La maladie alcoolique du foie et la stéatopathie métabolique figurent parmi les principales causes de morbi-mortalité dans les pays occidentaux en raison d'une accumulation progressive d'une fibrose dans le foie. Il n'existe à ce jour aucune molécule sûre et efficace dont l'effet antifibrosant ait formellement été démontré chez l'homme. Les macrophages du foie jouent un rôle central dans la pathogenèse de la fibrose hépatique en produisant des cytokines pro inflammatoires et fibrogéniques qui favorisent l'activation des cellules fibrogéniques du foie. L'autophagie est un processus de dégradation lysosomale qui présente des propriétés anti-inflammatoires en inhibant la production des cytokines pro-inflammatoires.Dans une première étude, nous démontrons que des souris invalidées pour le gène ATG5 dans la lignée myéloïde (Atg5Mye-/-) traitées par le CCl4, produisent une fibrose hépatique aggravée par rapport aux souris sauvages. En outre, les souris Atg5Mye-/- présentent une augmentation de l'atteinte hépatocytaire, du recrutement de cellules inflammatoires (monocytes et neutrophiles) et de la production des cytokines IL-1α et IL-1β. De plus, l'expression des marqueurs fibrogéniques est augmentée dans les myofibroblastes exposés à un milieu conditionné de macrophages ATG5-/- traités par le LPS par comparaison au milieu conditionné de macrophages sauvages. Ces effets sont reversés près prétraitement du milieu conditionné de macrophages ATG5-/- avec des anticorps neutralisant l'IL-1α et l'IL-1β. Enfin, l'administration simultanée d'un antagoniste de l'IL-1R1 aux souris Atg5Mye-/- traitées par le CCl4, atténuée l'atteinte hépatique et la fibrose, suggerant que les propriétés anti-inflammatoires et anti-fibrogéniques dans le foie de l'autophagie macrophagique sont influencés par l'IL-1α et l'IL-1β.Dans un deuxième temps, nous avons montré que les souris invalidées pour le récepteur CB2 dans les cellules myéloïdes (CB2Mye−/−) exprimaient fortement des gènes pro-inflammatoires et déclaraient une stéatose hépatique lors de l'induction alcoolique en comparaison aux souris sauvages. L'activation du récepteur CB2 par JWH-133 augmente l'autophagie des macrophages du foie chez les souris ayant reçu une alimentation alcoolisée, alors que cette autophagie est inhibée pour les souris CB2Mye−/− dans les mêmes conditions d'alimentation. Sur des cultures de macrophages péritonéaux, nous avons montré que JWH-133 limite l'induction des gènes inflammatoires provoquée par le LPS dans les macrophages péritonéaux sauvages, sauf pour les cellules déficientes en ATG5-, suggérant que les effets anti-inflammatoires et anti-stéatogènes du récepteur CB2 sont médiés par l'autophagie. En effet, les agonistes du récepteur CB2 pourraient jouer un rôle protecteur contre l'inflammation du foie et la stéatose induites par l'alcool chez l'individu sauvage, mais pas chez les souris ATG5Mye−/−.Ces résultats i) présentent l'autophagie des macrophages comme un nouveau processus anti-inflammatoire qui régule la fibrose hépatique et ii) identifient le récepteur CB2 comme un régulateur de l'autophagie dans les macrophages, qui protège de la stéatose induite par l'alcool par inhibition de l'inflammation hépatique. / Alcohol abuse and non-alcoholic fatty liver disease (NAFLD) are leading causes of liver-related morbi-mortality in Western countries that may lead to accumulation of fibrosis in the liver. Efficient treatments are lacking and there is currently no molecule approved for the treatment of liver fibrosis. Hepatic macrophages play a pivotal role in the initiation and perpetuation of the inflammatory response in fatty liver disease and in progression to fibrosis. Autophagy is a lysosomal degradation pathway that limits the production of pro-inflammatory cytokines. The aim of my thesis was to explore the contribution of macrophage autophagy on alcohol-induced liver injury and fibrosis.In a first study, we show that mice invalidated for the autophagy-gene ATG5 in myeloid cells (Atg5Mye-/- mice) develop exacerbated fibrosis as compared to WT littermates in response the hepatotoxin CCl4. Moreover, Atg5Mye-/- mice produce higher hepatic levels of IL-1α and IL-1β, and show enhanced inflammatory cell recruitment associated with exacerbated liver injury. Hepatic myofibroblasts exposed to the conditioned medium of macrophages from Atg5Mye-/- mice displayed increased profibrogenic gene expression, which could be blunted by neutralizing IL-1α and IL-1β in the conditioned medium of Atg5-/- macrophages. Finally, administration of an IL-1R1 antagonist to Atg5Mye-/- mice exposed to carbon tetrachloride blunted liver injury and fibrosis, revealing that the deleterious effects of macrophage autophagy invalidation are mediated through IL-1α/β.In a second study, we generated mice invalidated for CB2 receptor (CB2Mye−/− mice) in myeloid cells. These mice showed enhanced alcohol-induced pro-inflammatory gene expression and hepatic steatosis as compared to WT littermates. Conversely, mice administered JWH-133 show reduced alcohol-induced liver injury. Activation of the CB2 receptor by JWH-133 increased macrophage autophagy in the livers of alcohol-fed mice, whereas autophagy was inhibited of alcohol-fed CB2Mye−/− mice. In cultured peritoneal macrophages, JWH-133 reduced the induction of inflammatory genes by LPS in WT peritoneal macrophages, but not in ATG5-deficient cells, suggesting that the anti-inflammatory and anti-steatogenic effects of the CB2 receptor are mediated through autophagy. Indeed, the CB2 agonist could protect against alcohol-induced liver inflammation and steatosis in WT, but not in ATG5Mye−/− mice.These results uncover macrophage autophagy as a novel anti-inflammatory pathway that regulates liver fibrosis, and identify CB2 receptor in macrophages as regulator of autophagy that protects from alcohol-induced steatosis by inhibiting hepatic inflammation. Exploiting macrophage autophagy may therefore be an interesting novel target in the treatment of chronic liver disease.

Adipose tissue inflammation has an impact on liver health and it has been demonstrated that chronic alcohol consumption leads to the expression of pro-inflammatory markers in the adipose tissue. A thorough characterization of alcohol-induced adipose inflammation is lacking, and is important to understand in order to identify immune-related mechanisms that drive this phenomenon. Current therapeutic regimens for alcoholic liver disease are ineffective. It is critical to understand how other organs influence liver injury in this disease when developing novel and effective therapies in the future. Alcoholic liver disease exhibits a sexual dimorphism; women are more susceptible to liver injury than men and the same paradigm exists in rodent models. Here, I demonstrate that female mice have greater alcohol-induced adipose tissue inflammation than male mice, evidenced by greater expression of pro-inflammatory cytokines and cell markers. Further, female mice also exhibit higher expression of toll-like receptor genes in the adipose tissue, suggesting a potential role for the innate immune system in alcohol-induced adipose inflammation. Toll-like receptor 4 (TLR4) has been demonstrated to drive inflammation in both the liver and adipose tissue. I used both germline and conditional knockouts of Tlr4 to characterize alcohol-induced changes in the immune cell composition of adipose tissue. Alcohol increased the number of pro-inflammatory adipose tissue macrophages. This macrophage phenotype switching is partially dependent on TLR4; germline, but not myeloid-specific, Tlr4-deletion prevents macrophage phenotype switching. Overall, my work demonstrates that alcohol-induced adipose tissue inflammation is related to liver injury and that TLR4 contributes to adipose macrophage phenotype switching.