Kupffer cells (KC) play an important role in the pathogenesis of inflammato
ry liver diseases leading to fibrosis. Anti-inflammatory drugs are only eff
ective when administered at high doses that may cause side effects. Therefo
re, dexamethasone coupled to mannosylated albumin (Dexa(5)-Man(10)-HSA) was
designed by us to selectively deliver this anti-inflammatory drug to the K
C. The effectiveness of Dexa(5)-Man(10)-HSA was studied both in organ cultu
res and fibrosis induced by bile duct ligation (BDL) in rats. Dexa(5)-Man(1
0)-HSA accumulated in livers of both healthy and fibrotic rats (67% +/- 5%
and 70% +/- 9% of the dose, respectively) and uptake was found almost exclu
sively in KC. Active dexamethasone was liberated from its carrier, because
Dexa(5)-Man(10)-HSA could effectively inhibit nitric oxide (NO) and tumor n
ecrosis factor alpha (TNF-alpha) release in endotoxin-activated liver slice
s. In vivo, however, this was associated with increased collagen I and III
depositions and enhanced tissue inhibitor of metalloproteinase-1 (TIMP-1) m
RNA expression. This was accompanied by a decreased influx of reactive oxyg
en species (ROS) producing cells in the livers of BDL animals treated with
Dexa(5)-Man(10)-HSA as compared with untreated BDL rats. Dexa(5)-Man(10)-HS
A treatment also replenished the depleted glycogen stores in hepatocytes of
BDL livers. In conclusion, our studies showed selective delivery of dexame
thasone to KC with Dexa(5)-Man(10)-HSA. This conjugate reduced intrahepatic
ROS in vivo and TNF-alpha production in vitro and prevented glycogen deple
tion in vivo, indicating effective pharmacologic targeting. Dexa(5)-Man(10)
-HSA, however, also accelerated fibrogenesis, which was paralleled by TIMP-
1 mRNA induction. Targeting of dexamethasone to KC provides evidence for a
dual role of this cell type in fibrogenesis of BDL rats.