An Autophagy-Enhancing Drug Promotes Degradation of Mutant α1-Antitrypsin Z and Reduces Hepatic Fibrosis

T Hidvegi, M Ewing, P Hale, C Dippold, C Beckett… - Science, 2010 - science.org
T Hidvegi, M Ewing, P Hale, C Dippold, C Beckett, C Kemp, N Maurice, A Mukherjee
Science, 2010science.org
In the classical form of α1-antitrypsin (AT) deficiency, a point mutation in AT alters the folding
of a liver-derived secretory glycoprotein and renders it aggregation-prone. In addition to
decreased serum concentrations of AT, the disorder is characterized by accumulation of the
mutant α1-antitrypsin Z (ATZ) variant inside cells, causing hepatic fibrosis and/or
carcinogenesis by a gain–of–toxic function mechanism. The proteasomal and autophagic
pathways are known to mediate degradation of ATZ. Here we show that the autophagy …
In the classical form of α1-antitrypsin (AT) deficiency, a point mutation in AT alters the folding of a liver-derived secretory glycoprotein and renders it aggregation-prone. In addition to decreased serum concentrations of AT, the disorder is characterized by accumulation of the mutant α1-antitrypsin Z (ATZ) variant inside cells, causing hepatic fibrosis and/or carcinogenesis by a gain–of–toxic function mechanism. The proteasomal and autophagic pathways are known to mediate degradation of ATZ. Here we show that the autophagy-enhancing drug carbamazepine (CBZ) decreased the hepatic load of ATZ and hepatic fibrosis in a mouse model of AT deficiency–associated liver disease. These results provide a basis for testing CBZ, which has an extensive clinical safety profile, in patients with AT deficiency and also provide a proof of principle for therapeutic use of autophagy enhancers.
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