PROJECT SUMMARY
Alcohol-associated liver disease (ALD) is a significant health problem caused by excessive alcohol consumption.
ALD is generally discovered in association with fatty liver, steatosis, or fibrosis progression, leading to cirrhosis.
Unfortunately, there is no approved drug for ALD, and the current therapies rely on abstinence, immune
suppressants like corticosteroids, or liver transplantation in case of advanced cirrhosis. Studies suggest that
inflammation plays a significant role in ALD initiation and progression. Kupffer cells (KCs), the residing
macrophages in the liver, are mainly involved in hepatic inflammatory reactions. KCs, upon contact with injured
hepatocytes or gut bacterial endotoxins such as lipopolysaccharides (LPS), get activated and secrete
inflammatory cytokines, including TNF-α and start the inflammation. Pharmacological inhibition of KCs by small
molecules such as gadolinium chloride or decreasing intestinal bacterial load with antibiotics is shown to prevent
liver injury and ALD progression. Cyclic adenosine monophosphate (cAMP) signaling plays a significant role in
dampening hepatic injury and steatosis. Alcohol is known to increase the expression of cAMP degrading enzyme
phosphodiesterase 4 (PDE4). The upregulated PDE4 decreases the cAMP levels and induces liver
inflammation/injury. PDE4 inhibitors have been investigated to inhibit macrophage recruitment and activation in
ALD; however, the current PDE4 inhibitors such as rolipram and roflumilast are associated with severe side
effects, including nausea, vomiting, diarrhea, and dyspepsia. This study aims to inhibit PDE4B activity by novel
inhibitor KVA-D-88 in alcohol-induced steatosis. Our preliminary data show that KVA-D-88 is a potent and
selective PDE4B inhibitor with a suitable pharmacokinetic profile. The development of highly selective PDE4B
inhibitors such as KVA-D-88 directly applies to human ALD. However, PDE4B inhibition in other organs, such
as the brain, is known to produce severe side effects. Therefore, there is a need for KC-specific drug delivery to
enhance the drug efficacy and specificity. We will develop KVA-D-88 nanoparticles for liver-specific PDE4B
inhibition. Our specific aims are Aim 1 to establish the role of PDE4B inhibitor KVA-D-88 in ALD in vitro and
in vivo. In this aim, we will determine the specificity of KVA-D-88 to inhibit PDE4B isotype compared to PDE4D
isotype in alcohol-induced primary KCs, hepatocytes, and hepatic stellate cells (HSCs). Next, we will evaluate
the effect of KVA-D-88 mediated PDE4B inhibition on cAMP signaling, TNF-α induced ER stress, and ethanol-
induced toxicity in the modified NIAAA mouse model. Aim 2. Formulate and characterize KCs targeted KVA-
D-88 loaded polyethylene glycol (PEG) decorated solid lipid nanoparticles (SLNs). In this aim, we will
develop and characterize KCs targeted PEG-SLNs loaded with KVA-D-88. Next, we will evaluate the therapeutic
efficacy of KVA-D-88 loaded SLNs in the NIAAA model. This project is highly significant as it could provide us
with ALD therapy and a potential platform for nonalcoholic fatty liver disease (NAFLD) and cholestasis-induced
liver fibrosis.