David: CBL137 destabilizes chromatin in both host and HBV contexts. Interestingly, at low doses, it appears to selectively disrupt HBV cccDNA chromatin while leaving host chromatin largely unaffected. This selective vulnerability highlights CBL137’s potential as an antiviral—not only for HBV but possibly for other viruses that rely on similar chromatin-based mechanisms to establish infection.
While we currently lack direct evidence that CBL137 is effective against chronic HBV infection, particularly due to the presence of integrated viral DNA, we hypothesize that it may still exert an effect by limiting the transcriptional activity of integrated HBV, disrupting the reactivation of latent cccDNA pools, or sensitizing infected cells to immune clearance through chromatin remodeling.
Contagion: Can you explain the potential clinical significance of CBL137 in human hepatocytes? How might this drug be developed into a treatment for chronic hepatitis B?
David: "While it is still early to fully evaluate the clinical potential of CBL137, our data suggest that it is effective at preventing the establishment of HBV infection in newly infected hepatocytes. This points to a potential role for CBL137 as a prophylactic or early-intervention antiviral agent by interfering with the formation or transcriptional activation of cccDNA, which is essential for persistent HBV infection."
"However, CBL137 also has limitations. As a DNA intercalator, it poses potential concerns related to toxicity, especially with long-term use, which may limit its application in the treatment of chronic hepatitis B. Despite these challenges, the mechanistic insights we are gaining from studying how cccDNA is established and maintained are opening up new opportunities for therapeutic development. CBL137 serves as a valuable tool compound to probe HBV chromatin biology and identify novel vulnerabilities in the viral life cycle. These insights could guide the design of more selective and safer epigenetic therapies targeting HBV persistence."
Contagion: What challenges remain in understanding the complete mechanism behind the chromatinization of HBV cccDNA, and are there other viral genes or pathways that may also be targeted using this approach?
David: "Significant challenges remain in fully understanding the mechanisms regulating HBV cccDNA, which may involve post-translational modifications, non-coding RNAs, chromatin-compacting factors, and complex transcriptional dynamics. However, our new platform has been transformative, enabling us to study the earliest events of HBV infection in unprecedented detail. We are now leveraging this system both to dissect the molecular mechanisms underlying cccDNA regulation and to identify novel therapeutic targets."
What You Need To Know
The study demonstrates that nucleosome positioning on HBV cccDNA directly regulates transcription of the HBV X gene, essential for viral replication.
CBL137 destabilizes the chromatin structure of HBV cccDNA and shows potential as an antiviral agent by inhibiting HBV transcription and infection in human hepatocytes.
The research highlights a shift in antiviral strategies from inhibiting viral replication to targeting the epigenetic regulation of cccDNA, offering new opportunities for therapeutic development in chronic hepatitis B.
"We are just beginning to uncover the critical role that epigenetic mechanisms play in controlling cccDNA activity. Given these findings, it is both logical and likely that additional viral transcriptional events are also modulated by chromatinization and host chromatin architecture."
Contagion: How do your findings with CBL137 compare to current therapies for chronic hepatitis B, and could this represent a shift in how we approach treatment for this infection?
David: "Current therapies for chronic hepatitis B, such as nucleos(t)ide analogs, effectively suppress viral replication by inhibiting reverse transcription, but they do not target the viral reservoir—cccDNA—which remains transcriptionally active in infected hepatocytes. As a result, these therapies rarely achieve a functional cure, and treatment is often lifelong.
In contrast, our findings with CBL137 suggest a fundamentally different approach. CBL137 targets the epigenetic regulation of HBV by disrupting the chromatin structure of cccDNA, thereby silencing its transcriptional activity. This represents a shift from inhibiting viral replication to directly interfering with the persistence and transcriptional output of the viral reservoir itself."
"While CBL137 has limitations—including its role as a DNA intercalator, which may restrict its use in chronic settings—its selective action on HBV chromatin at low doses is both intriguing and promising. More importantly, this work provides a proof-of-concept that viral chromatin can be selectively targeted. This insight could open the door to a new class of therapeutics aimed at silencing or destabilizing cccDNA through epigenetic modulation, rather than direct antiviral inhibition."
"In that sense, CBL137 doesn’t just represent a potential therapeutic—it represents a conceptual shift in how we think about curing HBV: not only by suppressing the virus, but by reprogramming or disabling its chromatin to achieve long-term control or even clearance."
Reference
Prescott NA, Biaco T, Mansisidor A, et al. A nucleosome switch primes hepatitis B virus infection. Cell. February 20, 2025. Accessed April 17, 2025. doi:10.1016/j.cell.2025.01.033