Liver Disease NASH/Fibrosis Model

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Liver Disease NASH/Fibrosis Model Please contact: Dipti Deshpande PhD ddeshpande@woodlandpharma.com or Carol Gebert PhD cgebert@woodlandbiosciences.com 617-513-5280

Liver Diseases Comprise a Growing Market NAFLD: 10-20% of Americans may suffer undiagnosed. NASH: Estimated to affect 2-5% of Americans. Cirrhosis: Approx. 25% of NASH patients progress. Liver Cancer: Third highest cancer mortality, globally.

Mouse Non Alcoholic Steatohepatitis (NASH) Model: 1. Pancreas b-cell insult (STZ) and subsequent liver injury in pups. 2. High fat diet-induced obesity. 3. Progressive liver disease leading to the induction of liver fibrosis. Induction of Macrophage-led Injury to the Liver

The Role of Obesity in Macrophage Accumulation is Well Established The Role of Macrophages in Fibrogenesis is Well Established

NASH Model Details at Woodland Status NASH/Liver fibrosis mouse model High fat diet induced NASH/Liver fibrosis rat model Carbohydrate-driven, under development Involves a 2 hit approach - 1 st hit chemical intervention leads to metabolic distress - 2 nd hit dietary intervention that enhances metabolic distress and induces fibrotic remodeling of the liver Animals develop type I diabetes and a fibrotic liver with eventual development of hepatocellular carcinoma (HCC) Involves a dietary intervention alone where high carbohydrate and cholesterol diet leads to metabolic disease and fibrotic remodeling of the liver Animals develop type II diabetes and a fibrotic liver with hyperglycemia, dyslipidemia, liver steatosis, abdominal fat deposition, hypertension and hyperinsulinemia. Closer to the majority of human disease as it involves dietary intervention alone May progress to HCC Currently in collaborator lab

NASH model development Study Plan Chemical hit #1: STZ injection in pups 2 nd Hit: HIGH FAT DIET (Week 5-17) TIMELINE (Weeks) 0...1...1.2...4...5...7...9...11...13...15...17 General Body weight Liver weight Liver to body weight ratio Plasma Glucose ALT/AST Inflammatory markers ELF Score Triglycerides Female C57 (pregnant) ANALYSES (Bold are standard) Birth of pups Histopathology Liver H & E NAS Score Sirius Red Collagen/fibrosis Oil Red O - Steatosis Liver Inflammatory markers ELF Score Hydroxyproline Triglycerides Fatty Liver NASH Fibrosis Hepatocellular Nodule Hepatocellular carcinoma COLLABORATORS Woodland Biosciences Histologistics Tufts Veterinary School Brandeis University

Liver weight (grams) Liver to bodyweight ratio (%) NASH model: Data Macroscopic view of the liver CONTROL 2.5 2 Liver weights 9 8 7 Liver/ Body Weight Ratio 1.5 6 5 1 4 3 0.5 2 1 0 Control NASH Liver 0 Control NASH Liver BLOOD GLUCOSE (mg/dl) Animal Age Week 5 Week 7 Week 10 Week 12 Week 14 Control 198 + 14 247 + 48 149 + 28 186 + 1.5 271 + 34 NASH NASH Liver LIVER NASH 422 + 173 435 + 96 467 + 110 432 + 147 564 + 162

NASH model: Histological parameters Steatosis

PICROSIRIUS RED PICROSIRIUS RED (POLARIZED) Fibrosis Score NASH model development Collagen Expression Picrosirius Red stains collagen I and III fibers CONTROL NASH Liver 2.5 2 1.5 1 0.5 0 Large collagen fibers are orange under polarized light * * - Sirius red positive fibrosis staining

Weight in grams Body weight (grams) NASH model development Diet Optimization Comparative evaluation of High fat diet (Diet A) versus modified high fat diet (Diet B) supplementation on development of NASH in mice 40.00 30.00 20.00 10.00 0.00 Terminal body weight Diet A Diet A Diet B Diet B 40.00 35.00 30.00 25.00 20.00 15.00 10.00 5.00 Body weight measurements- Diet A vs Diet B Diet A Diet B 0.00 0.00 10.00 20.00 30.00 40.00 50.00 60.00 70.00 Days post weaning Mean body weight (terminal) was higher in the mice fed with diet A as compared to the mice receiving diet B

Weight in grams Ratio (%) NASH model development Diet Optimization Comparative evaluation of High fat diet (Diet A) versus modified high fat diet (Diet B) supplementation on development of NASH in mice Diet A Diet B 4.00 Terminal liver weight 15.00 Liver/body weight ratio Gross liver - Diet A 3.00 10.00 2.00 1.00 5.00 0.00 Diet A Diet B 0.00 Diet A Diet B Gross liver Diet B The mean liver weights and the mean % liver to body weight ratios of the animals receiving diet B were greater than the animals receiving diet A The livers harvested from the animals receiving diet B appeared lighter (pale appearance) in color than the livers harvested from animals receiving diet A

Random blood glucose (mg/dl) NASH model development Diet Optimization Comparative evaluation of High fat diet (Diet A) versus modified high fat diet (Diet B) supplementation on development of NASH in mice 800 700 600 Glucose measurements-post weaning Diet A Diet B 500 400 300 200 100 0 Week 5 Week 7 Week 10 Week 12 Week 14 The mean blood glucose levels were similar across the 2 study groups indicating hyperglycemia/diabetes (glucose > 300mg/dl)

Diet B Diet A NASH model development Diet Optimization Comparative evaluation of High fat diet (Diet A) versus modified high fat diet (Diet B) supplementation on development of NASH in mice H&E 10X ORO 20X Picrosirius Red 20X Animals receiving diet-b showed greater fibrosis (picrosirius red staining) and greater steatosis (oil red O Staining) than animals receiving diet-a Digitized NAFLD imaging/scoring is currently under investigation

NASH model development Diet Optimization Comparative evaluation of High fat diet (Diet A) versus modified high fat diet (Diet B) supplementation on development of NASH in mice 4.00 3.00 2.00 1.00 Diet A Diet B 4.00 3.00 2.00 1.00 0.00 0.00 Terminal Fibrosis Score * (Certified pathology lab-manual scoring-blinded analysis) Terminal NASH Activity scoring The terminal fibrosis score and NASH activity score was greater for the animals receiving diet-b relative to animals receiving diet-a

Diet B + drug X Diet B Saline Sample study results histology diet B and drug X H&E 10X ORO 20X Picrosirius Red 20X Treatment with drug X has a marginal effect in reducing fatty deposits and collagenstaining in the liver tissue Digitized NAFLD imaging/scoring and statistical evaluation is currently under investigation

Biomarker Analyses ANALYTES* Plasma Galectin-3 (Gal-3) ALT/AST Inflammatory markers ELF Score Triglycerides Liver Galectin 3 (Gal-3) Inflammatory markers ELF Score Hydroxyproline Triglycerides * Additional charges incurred Peggy Sue Wes

Other In-Vitro Capabilities ELISA Capillary western blot (CLIA) Luminex qrt-pcr Flow cytometry (available through Worcester partners ATR) Fully capable to be your resource for inflammation >30 Cytokines >40 Mabs >270 human cancer cell lines in 19 indications Bench-scale protein production Cytokine production and bioassays Cell-Based Assays (oncology & Inflammation

Facilities In vitro laboratories Principal lab space for in vitro operations at our strategic partner, SBH Sciences in Natick, MA In vivo laboratories Animal rooms are within the AAALAC-accredited facilities at WPI, located in Gateway Park in Worcester, MA

Woodland Biosciences: A strategic alliance of CRO specialists Plus an extensive network of partners In vivo lab 60 Prescott Street, Worcester, MA In vitro lab Natick, MA