Naugler WE, Sakurai T, Kim S, Maeda S, Kim K, Elsharkawy AM, Karin MGender disparity in liver cancer due to sex differences in MyD88-dependent IL-6 production. Science 317: 121-124

Laboratory of Gene Regulation and Signal Transduction, Department of Pharmacology and Cancer Center, University of California, San Diego, CA 93093, USA.
Science (Impact Factor: 33.61). 08/2007; 317(5834):121-4. DOI: 10.1126/science.1140485
Source: PubMed

ABSTRACT Hepatocellular carcinoma (HCC), the most common liver cancer, occurs mainly in men. Similar gender disparity is seen in mice given a chemical carcinogen, diethylnitrosamine (DEN). DEN administration caused greater increases in serum interleukin-6 (IL-6) concentration in males than it did in females. Furthermore, ablation of IL-6 abolished the gender differences in hepatocarcinogenesis in mice. DEN exposure promoted production of IL-6 in Kupffer cells (KCs) in a manner dependent on the Toll-like receptor adaptor protein MyD88, ablation of which also protected male mice from DEN-induced hepatocarcinogenesis. Estrogen inhibited secretion of IL-6 from KCs exposed to necrotic hepatocytes and reduced circulating concentrations of IL-6 in DEN-treated male mice. We propose that estrogen-mediated inhibition of IL-6 production by KCs reduces liver cancer risk in females, and these findings may be used to prevent HCC in males.

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Available from: Ahmed eisawy Elsharkawy, Sep 28, 2015
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    • "In contrast, other experiments have reported a tumor-enhancing effect of ovariectomy on liver cancers (Vesselinovitch et al, 1980; Nakatani et al, 2001). In addition, rodent experiments have demonstrated the ability of estrogens to protect against diethylnitrosamine-induced liver cancer due to their ability to inhibit the production of interleukin-6 (IL-6), a multifunctional cytokine (Naugler et al, 2007). Whether a similar phenomenon occurs in human liver cancer is not clear. "
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    ABSTRACT: Background: Hepatocellular carcinoma (HCC) occurs less commonly among women than men in almost all regions of the world. The disparity in risk is particularly notable prior to menopause suggesting that hormonal exposures during reproductive life may be protective. Exogenous oestrogenic exposures such as oral contraceptives (OCs), however, have been reported to increase risk, suggesting that estrogens may be hepatocarcinogenic. To examine the effects of reproductive factors and exogenous hormones on risk, we conducted a prospective analysis among a large group of US women. Methods: In the Liver Cancer Pooling Project, a consortium of US-based cohort studies, data from 799,500 women in 11 cohorts were pooled and harmonised. Cox proportional hazards regression models were used to generate hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations of reproductive factors and exogenous hormones with HCC (n=248). Results: Bilateral oophorectomy was associated with a significantly increased risk of HCC (HR=2.67, 95% CI=1.22-5.85), which did not appear to be related to a shorter duration of exposure to endogenous hormones or to menopausal hormone therapy use. There was no association between OC use and HCC (HR=1.12, 95% CI=0.82-1.55). Nor were there associations with parity, age at first birth, age at natural menopause, or duration of fertility. Conclusions: The current study suggests that bilateral oophorectomy increases the risk of HCC but the explanation for the association is unclear. There was no association between OC use and HCC risk. Examination of endogenous hormone levels in relation to HCC may help to clarify the findings of the current study.
    British Journal of Cancer 03/2015; 112(7). DOI:10.1038/bjc.2015.58 · 4.84 Impact Factor
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    • "Here, we also demonstrate that HBx induces the expression of pro-inflammatory cytokines IL-6, IL-8, and CXCL2 in hepatocytes in an autophagy-dependent manner. High serum level of IL-6 has been shown to predict future HCC development in patients with chronic hepatitis B whereas genetic ablation of IL-6 abolished hepatocarcinogenesis in an animal model of HCC (Naugler et al., 2007; Wong et al., 2009). IL-6 also mediates the inhibitory effect of HBx on liver regeneration (Qu etier et al., 2013). "
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    ABSTRACT: HBV and one of its encoded proteins, HBV X protein (HBx), have been shown to induce autophagy in hepatoma cells. Substantial evidence indicates that autophagy is a potent suppressor of inflammation. However, sporadic reports suggest that autophagy could promote pro-inflammatory cytokine expression and inflammation in some biological contexts. Here we show that overexpression of HBx induces LC3B-positive autophagosome formation, increases autophagic flux and enhances the expression of ATG5, ATG7, and LC3B-II in normal hepatocytes. Abrogation of autophagy by small interfering RNA against ATG5 and ATG7 prevents HBx-induced formation of autophagosomes. Autophagy inhibition also abrogates HBx-induced activation of nuclear factor-κB and production of interleukin-6 (IL-6), IL-8 and CXCL2. These findings suggest that autophagy is required for HBx-induced nuclear factor-κB activation and pro-inflammatory cytokine production and could shed new light on the complex role of autophagy in the modulation of inflammation. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Journal of Cellular Physiology 02/2015; 230(10). DOI:10.1002/jcp.24967 · 3.84 Impact Factor
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    • "HCC commonly occurs in patients secondary to chronic hepatitis or cirrhosis resulting from either hepatitis B or C virus infection, or from non-virus-related causes, such as alcohol or aflatoxin exposure (2–4). A persistent, non-specific and ineffective immune system activation within the chronically inflamed liver is hypothesized to induce carcinogenesis (2,3,5). Current treatments for HCC include surgical resection, liver transplantation and local ablative therapies, such as percutaneous ethanol injection, thermal ablation and intra-arterial chemoembolization (6). "
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    ABSTRACT: Tumor-infiltrating lymphocytes may be a manifestation of antitumor immunity. In the present study, hepatocellular carcinoma (HCC) and pericancerous non-tumor liver tissues samples were obtained from 86 surgical patients who had not received preoperative treatment. The cellular expression levels of CD4 and CD8 were immunohistochemically examined in the two tissue groups using tissue microarrays, to evaluate their clinicopathological relevance. Immunohistochemically, CD4 and CD8 T cells were observed in the tumor parenchyma and tumor stroma, and the intensity of CD4 and CD8 immunoreactivity was homogeneous in all HCC samples examined. Morphometrically, the average numbers of CD4- and CD8-positive T cells were significantly increased in the tumor stroma, compared with those in the tumor parenchyma (tumor stroma versus tumor parenchyma: 22±3.6 versus 7.4±0.9 in CD4, 32.8±4.2 versus 16±2.5 in CD8; both P<0.01). Furthermore, the average numbers of CD8-positive T cells in the tumor parenchyma and stroma were significantly increased, compared with the average numbers of CD4-positive cells (P<0.05). In addition, in the tumor parenchyma and stroma, the average numbers of CD8 T cells were significantly higher in patients with tumor diameters ≤5 cm compared with those in patients with tumor diameters >5 cm (diameter ≤5 cm versus diameter >5 cm: 18.1±3.3 versus 12.2±3.8 in tumor parenchyma, 36.5±4.8 versus 21.9±8.9 in tumor stroma; both P<0.05). In addition, CD8 expression was significantly enhanced in patients with chronic hepatitis and cirrhosis, compared with paired tumor parenchymal tissues (P<0.01). Furthermore, a significant positive correlation was observed between CD4 and CD8 expression in the tumor parenchyma and stroma (both P<0.001). These observations suggest that tumor parenchyma- or stroma-infiltrating CD8 T cells may be involved in HCC tumor diameter control.
    Oncology letters 11/2014; 8(5):2284-2290. DOI:10.3892/ol.2014.2516 · 1.55 Impact Factor
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