Manipulating PP2Acα-ASK-JNK signaling to favor apoptotic over necroptotic hepatocyte fate reduces the extent of necrosis and fibrosis upon acute liver injury.

In the widely used Carbon tetrachloride (CCl4)-induced acute liver injury (ALI) mouse model, hepatocytes are known to die from programmed cell death (PCD) processes including apoptosis and necroptosis. Both in vivo and in vitro experiments showed that CCl4 treatment could induce both apoptosis and necroptosis. Treatment of mice with the apoptosis inducer SMAC mimetic reduced necroptosis, led to less pronounced liver damage, and improved overall liver function. By LC-MS/MS, we found that PP2Acα expression was increased in ALI mice liver, and we confirmed its high expression in subacute hepatitis patients. We observed that ALI severity (including aggravated fibrogenesis) was significantly alleviated in hepatocyte-specific PP2Acα conditional knockout (PP2Acα cKO) mice. Furthermore, the relative extent of apoptosis over necroptosis was increased in the PP2Acα cKO ALI mice. Pursuing the idea that biasing the type of PCD towards apoptosis may reduce liver damage, we found that treatment of PP2Acα cKO ALI mice with the apoptosis inhibitor z-Vad-fmk increased the extent of necroptosis and caused severer damage. Mechanistically, disruption of PP2Acα prevents the dephosphorylation of pASK1(Ser967), thereby preventing the sustained activation of JNK. Inhibition of PP2Acα prevents CCl4-induced liver injury and fibrogenesis by disrupting ASK/JNK pathway mediated PCD signaling, ultimately improving liver function by biasing hepatocytes towards an apoptotic rather than necroptotic cell fate. Thus, targeting PP2A and/or ASK1 to favor apoptotic over necroptotic hepatocyte fate may represent an attractive therapeutic strategy for treating ALI.

Targeting glutaminase 1 attenuates stemness properties in hepatocellular carcinoma by increasing reactive oxygen species and suppressing Wnt/beta-catenin pathway.

BACKGROUND: Hepatocellular carcinoma (HCC) is an aggressive malignant disease with poor prognosis. Recent advances suggest the existence of cancer stem cells (CSCs) within liver cancer, which are considered to be responsible for tumor relapse, metastasis, and chemoresistance. However, novel therapeutic approaches for eradicating CSCs are yet to be established. Here, we aimed to identify the role of glutaminase 1 (GLS1) in stemness, and the feasibility that GLS1 serves as a therapeutic target for elimination CSCs as well as the possible mechanism. METHODS: Publicly-available data from the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) was mined to unearth the association between GLS1 and stemness phenotype. Using big data, human tissues and multiple cell lines, we gained a general picture of GLS1 expression in HCC progression. We generated stable cell lines by lentiviral-mediated overexpression or CRISPR/Cas9-based knockout. Sphere formation assays and colony formation assays were employed to analyze the relationship between GLS1 and stemness. A series of bioinformatics analyses and molecular experiments including qRT-PCR, immunoblotting, flow cytometry, and immunofluorescence were employed to investigate the role of GLS1 in regulating stemness in vitro and in vivo. FINDINGS: We observed GLS1 (both KGA and GAC isoform) is highly expressed in HCC, and that high expression of GAC predicts a poor prognosis. GLS1 is exclusively expressed in the mitochondrial matrix. Upregulation of GLS1 is positively associated with advanced clinicopathological features and stemness phenotype. Targeting GLS1 reduced the expression of stemness-related genes and suppressed CSC properties in vitro. We further found GLS1 regulates stemness properties via ROS/Wnt/ß-catenin signaling and that GLS1 knockout inhibits tumorigenicity in vivo. INTERPRETATION: Targeting GLS1 attenuates stemness properties in HCC by increasing ROS accumulation and suppressing Wnt/ß-catenin pathway, which implied that GLS1 could serve as a therapeutic target for elimination of CSCs.

Development and Validation of a Three-gene Prognostic Signature for Patients with Hepatocellular Carcinoma.

Hepatocellular carcinoma (HCC) is the leading cause of cancer-related death worldwide, because recurrence often occurs in most HCC patients undergoing hepatectomy. It is necessary to identify patients with high risk for recurrence and adopt effective therapies. An obstacle to monitor patients at high risk for poor prognosis has been the lack of useful predictive biomarkers. Fortunately, recent progress in system biology allows to screen the biomarkers for HCC prognosis in a high-throughput manner. In this study, we performed systematic Kaplan-Meier survival analysis of the whole mRNA transcriptomics based on the Cancer Genome Atlas project (TCGA) and developed a three-gene prognostic signature composing of three genes UPB1, SOCS2 and RTN3. The model was validated in two independent microarray data sets retrieved from Gene Expression Omnibus (GEO) and the expression pattern of these three predictive genes in HCC was confirmed by western blot and immunohistochemistry with our HCC samples. In conclusion, our results showed that this three-gene signature has prognostic value for HCC patients.

Paired assessment of liver telomere lengths in hepatocellular cancer is a reliable predictor of disease persistence.

In the present study, we used a small series of highly defined patients, where we had matched timed peripheral blood samples (PBS), as well as paired liver biopsies obtained during collection of blood samples from patients with diagnosed hepatocellular carcinoma (HCC) and compared the correlation between the changes of telomere lengths in these defined samples. Patients included had either HCC alone or in conjunction with either pre-existing hepatitis B virus (HBV) or hepatitis C virus (HCV) infection. PCR-based assay incorporating primers to the telomeric hexamer repeats to polymerize and detect telomeric DNA was used. The average telomere length for each independent assessment was measured by seeing the differences in the intensity of the sample's telomere signal (T) to the signal from a single-copy gene (S-, ß-globin) to estimate the standard ratio. Our results provide the first convincing evidence that PBS may be utilized to assay telomere shortening as a predictor for disease persistence in HCC resulting after HBV or HCV infection, but not in non-infectious cause-stimulated HCC. These findings provide incipient opportunity to develop telomere length assessment as a biomarker tool for prediction of HCC in patients with HBV or HCV infection, as well as to gauge responses to chemotherapy and other treatment modalities.

PP2Acα positively regulates the termination of liver regeneration in mice through the AKT/GSK3ß/Cyclin D1 pathway.

BACKGROUND & AIMS: Liver injury triggers a highly organized and ordered liver regeneration (LR) process. Once regeneration is complete, a stop signal ensures that the regenerated liver is an appropriate functional size. The inhibitors and stop signals that regulate LR are unknown, and only limited information is available about these mechanisms. METHODS: A 70% partial hepatectomy (PH) was performed in hepatocyte-specific PP2Acα-deleted (PP2Acα(-/-)) and control (PP2Acα(+/+)) mice. LR was estimated by liver weight, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels and cell proliferation, and the related cellular signals were analyzed. RESULTS: We found that the catalytic subunit of PP2A was markedly upregulated during the late stage of LR. PP2Acα(-/-) mice showed prolonged LR termination, an increased liver size compared to the original mass and lower levels of serum ALT and AST compared with control mice. In these mice, cyclin D1 protein levels, but not mRNA levels, were increased. Mechanistically, AKT activated by the loss of PP2Acα inhibited glycogen synthase kinase 3ß (GSK3ß) activity, which led to the accumulation of cyclin D1 protein and accelerated hepatocyte proliferation at the termination stage. Treatment with the PI3K inhibitor wortmannin at the termination stage was sufficient to inhibit cyclin D1 accumulation and hepatocyte proliferation. CONCLUSIONS: PP2Acα plays an essential role in the proper termination of LR via the AKT/GSK3ß/Cyclin D1 pathway. Our findings enrich the understanding of the molecular mechanism that controls the termination of LR and provides a potential therapeutic target for treating liver injury.

Deformation vector fields (DVF)-driven image reconstruction for 4D-CBCT.

BACKGROUND: High quality 4D-CBCT can be obtained by deforming a planning CT (pCT), where the deformation vector fields (DVF) are estimated by matching the forward projections of pCT and 4D-CBCT projections. The matching metric used in the previous study is the sum of squared intensity differences (SSID). The scatter signal level in CBCT projections is much higher than pCT, the SSID metric may not lead to optimal DVF. OBJECTIVE: To improve the DVF estimation accuracy, we develop a new matching metric that is less sensitive to the intensity level difference caused by the scatter signal. METHODS: The negative logarithm of correlation coefficient (NLCC) is used as the matching metric. A non-linear conjugate gradient optimization algorithm is used to estimate the DVF. A 4D NCAT phantom and an anthropomorphic thoracic phantom were used to evaluate the NLCC-based algorithm. RESULTS: In the NCAT phantom study, the relative reconstruction error is reduced from 18.0% in SSID to 14.13% in NLCC. In the thoracic phantom study, the root mean square error of the tumor motion is reduced from 1.16 mm in SSID to 0.43 mm in NLCC. CONCLUSION: NLCC metric can improve the image reconstruction and motion estimation accuracy of DVF-driven image reconstruction for 4D-CBCT.

Reconstructing cone-beam CT with spatially varying qualities for adaptive radiotherapy: a proof-of-principle study.

With the aim of maximally reducing imaging dose while meeting requirements for adaptive radiation therapy (ART), we propose in this paper a new cone beam CT (CBCT) acquisition and reconstruction method that delivers images with a low noise level inside a region of interest (ROI) and a relatively high noise level outside the ROI. The acquired projection images include two groups: densely sampled projections at a low exposure with a large field of view (FOV) and sparsely sampled projections at a high exposure with a small FOV corresponding to the ROI. A new algorithm combining the conventional filtered back-projection algorithm and the tight-frame iterative reconstruction algorithm is also designed to reconstruct the CBCT based on these projection data. We have validated our method on a simulated head-and-neck (HN) patient case, a semi-real experiment conducted on a HN cancer patient under a full-fan scan mode, as well as a Catphan phantom under a half-fan scan mode. Relative root-mean-square errors (RRMSEs) of less than 3% for the entire image and ~1% within the ROI compared to the ground truth have been observed. These numbers demonstrate the ability of our proposed method to reconstruct high-quality images inside the ROI. As for the part outside ROI, although the images are relatively noisy, it can still provide sufficient information for radiation dose calculations in ART. Dose distributions calculated on our CBCT image and on a standard CBCT image are in agreement, with a mean relative difference of 0.082% inside the ROI and 0.038% outside the ROI. Compared with the standard clinical CBCT scheme, an imaging dose reduction of approximately 3-6 times inside the ROI was achieved, as well as an 8 times outside the ROI. Regarding computational efficiency, it takes 1-3 min to reconstruct a CBCT image depending on the number of projections used. These results indicate that the proposed method has the potential for application in ART.