Nicola Harris

Background and Aims: The NUC-B study showed that a 4-month course of pegylated interferon-alpha (PEG-IFNα) enhanced the outcome and reduced hepatic flares following nucleos(t)ide analog (NUC) withdrawal in HBeAg-negative chronic hepatitis B. Here, we investigated differential T- and regulatory B-cell (B _REG ) changes before and during these interventions in a substudy of 41 representative patients. Approach and Results: Antigen-specific T cells were primarily evaluated using quality-controlled IFN-γ ELISpot with 15 pools of genotype-matched HBV core/small-surface peptides, confirmed by multiparameter flow cytometry. B-cell responses were tested with multiparameter flow cytometry and intracellular IL-10 staining. Broader baseline IFN-γ-producing-HBV-specific T cells correlated with higher sustained off-treatment viral control and reduced flares. PEG-IFNα led to a transient reduction in HBV-specific T cells that persisted for over 1 month after treatment. B _REG producing the immunosuppressive cytokine IL-10 expanded more than 5-fold during adjuvant PEG-IFNα. The kinetics of B _REG induction correlated with flares in both arms and showed a significant inverse temporal correlation with IFN-γ-producing-HBV-specific T-cell frequencies. Conclusions: Baseline breadth and magnitude of HBV-specific T cells should be evaluated as biomarkers to select patients more likely to have favorable outcomes with NUC withdrawal ±PEG-IFNα. The expansion of B _REG provides insights into homeostatic mechanisms induced by PEG-IFNα and withdrawal flares, which could constrain HBV-specific T cells while limiting inflammation.

The global burden of liver cancer is increasing. Timely diagnosis is important for optimising the limited available treatment options. Understanding the metabolic consequences of hepatocellular carcinoma (HCC) may lead to more effective treatment options. We aimed to document metabolite differences between HCC and matched surrounding tissues of varying aetiology, obtained at the time of liver resection, and to interpret metabolite changes with clinical findings. High-resolution magic angle spinning nuclear magnetic resonance (HRMAS-NMR) spectroscopy analyses of N = 10 paired HCC and surrounding non-tumour liver tissue samples were undertaken. There were marked HRMAS-NMR differences in lipid levels in HCC tissue compared to matched surrounding tissue and more subtle changes in low-molecular-weight metabolites, particularly when adjusting for patient-specific variability. Differences in lipid-CH₃, lipid-CH₂, formate, and acetate levels were of particular interest. The obvious differences in lipid content highlight the intricate interplay between metabolic adaptations and cancer cell survival in the complex microenvironment of liver cancer. Differences in formate and acetate might relate to bacterial metabolites. Therefore, documentation of metabolites in HCC tissue according to histology findings in patients is of interest for personalised medicine approaches and for tailoring targeted treatment strategies.

Alcohol-related liver disease (ALD) encompasses a range of pathological conditions that are complex to study at the clinical and preclinical levels. Despite the global burden of ALD, there is a lack of effective treatments, and mortality is high. One of the reasons for the unsuccessful development of novel therapies is that experimental studies are hindered by the challenge of recapitulating this multifactorial disorder in vitro, including the contributions of hepatotoxicity, impaired lipid metabolism, fibrosis and inflammatory cytokine storm, which are critical drivers in the pathogenesis of ALD in patients and primary targets for drug development. Here, we present the unique characteristics of the culture of human precision-cut liver slices (PCLS) to replicate key disease processes in ALD. PCLS were prepared from human liver specimens and treated with ethanol alone or in combination with fatty acids and lipopolysaccharide (FA + LPS) for up to 5 days to induce hepatotoxic, inflammatory and fibrotic events associated with ALD. Alcohol insult induced hepatocyte death which was more pronounced with the addition of FA + LPS. This mixture showed a significant increase in the cytokines conventionally associated with the prototypical inflammatory response observed in severe ALD, and interestingly, alcohol alone exhibited a different effect. Profibrogenic activation was also observed in the slices and investigated in the context of slice preparation. These results support the versatility of this organotypic model to study different pathways involved in alcohol-induced liver damage and ALD progression and highlight the applicability of the PCLS for drug discovery, confirming their relevance as a bridge between preclinical and clinical studies.

Neuroendocrine liver metastases (LM-NEN) develop in a considerable proportion of patients with gastroenteropancreatic neuroendocrine neoplasms. There is a paucity of experimental models that accurately recapitulate this complex metastatic human liver microenvironment precluding scientific and clinical advancements. Here, we describe the development of a novel personalised immunocompetent precision cut tumour slice (PCTS) model for LM-NEN using resected human liver tissue. The histological assessment throughout the culture demonstrated that slices maintain viability for at least 7 days and retain the cellular heterogeneity of the original tumour. Essential clinical features, such as patient-specific histoarchitecture, tumour grade, neuroendocrine differentiation and metabolic capacity, are preserved in the slices. The PCTS also replicate the tumor-specific immunological profile as shown by the innate and adaptive immunity markers analysis. Furthermore, the study of soluble immune checkpoint receptors in the culture supernatants proves that these immunomodulators are actively produced by LM-NEN and suggests that this process is epithelium-dependent. This model can be employed to investigate these pathways and provides a powerful platform for mechanistic, immunological and pre-clinical studies.