Article
作者: Li, Xuri ; Chen, Yumeng ; Wu, Dongbo ; Hu, Yan ; Friedman, Scott L ; Rafii, Shahin ; Luo, Qinghua ; Chai, Dong ; Xiao, Chengju ; Ye, Tinghong ; Zhong, Weiting ; Dong, Haohao ; Cao, Zhongwei ; Yang, Xinchun ; He, Huanhuan ; Du, Xiao ; Cai, Yun ; Yang, Biao ; Liang, Beibei ; Bai, Nan ; Zhao, Yanping ; Chang, Junlei ; Gao, Jinhang ; Yang, Pengbo ; Chen, Jie ; Zhang, Hua ; Zhang, Guixiang ; Wang, Chen ; Wang, Hongjun ; Guo, Zhiqing ; Peng, Liang ; Yi, Cheng ; Zhao, Chengjian ; Ding, Bi-Sen ; Zhang, Daoguang ; Teng, Yangjing ; Qi, Xiaolong
Liver fibrosis is a prominent pathological process contributing to death from hepatic diseases, including metabolic dysfunction-associated steatohepatitis (MASH). There is limited treatment for liver fibrosis. Here, we find that upregulation of Rho-associated coiled-coil containing kinase 2 (ROCK2) in liver endothelial cells (ECs) and perivascular hepatic stellate cells (HSCs) causes vascular niche dysfunction and triggers pro-fibrotic angiocrine signaling. Based on the vascular druggable target ROCK2, we developed its selective inhibitor showing anti-fibrotic potency in preclinical models and human patients. The ROCK2-selective inhibitor TDI01 restored vascular phenotype and alleviated fibrosis in rodent and minipig MASH models. A phase 1 clinical trial (ChiCTR2200058868) of TDI01 demonstrated its favorable pharmacokinetics and safety in humans. An extended clinical trial (ChiCTR2400082056) showed a trend toward reducing liver fibrosis in five of six patients after TDI01 treatment. Thus, we discover vascular ROCK2 as a pro-fibrotic target, and development of an inhibitor selectively targeting angiocrine ROCK2 may provide a treatment of liver fibrosis in human patients.