Abstract

Hepatocellular carcinoma (HCC) is a major leading cause of cancer-related death worldwide. Alpha fetoprotein (AFP) is reactivated in a majority of hepatocellular carcinoma (HCC) and associated with poor patient outcomes. Although increasing evidence has shown that AFP can regulate HCC cell growth, the precise functions of AFP in hepatocarcinogenesis and the associated underlying mechanism remain incompletely understood. In this study, we demostrated that depleting AFP significantly suppressed diethylnitrosamine (DEN)-induced liver tumor progression in an AFP gene-deficient mouse model. Similarly, knocking down AFP expression inhibited human HCC cell proliferation and tumor growth by inducing apoptosis. AFP expression level was inversely associated with the apoptotic rate in mouse and human HCC specimens. Investigation of potential cross-talk between AFP and apoptotic signaling revealed that AFP exerted its growth-promoting effect by suppressing the Fas/FADD-mediated extrinsic apoptotic pathway. Mechanistically, AFP bound to the RNA-binding protein HuR, increasing the accumulation of HuR in the cytoplasm and subsequent inhibition of Fas mRNA translation. In addition, we found that inhibiting AFP enhanced the cytotoxicity of therapeutics to AFP-positive HCC cells by activating HuR-mediated Fas/FADD apoptotic signaling. Conclusion: Our study defined the pro-oncogenic role of AFP in HCC progression and uncovered a novel antiapoptotic mechanism connecting AFP to HuR-mediated Fas translation. Our findings suggest that AFP is involved in the pathogenesis and chemosensitivity of HCC and that blockade of AFP may be a promising strategy to treat advanced HCC.

Highlights

  • Hepatocellular carcinoma (HCC) is one of the most common malignances worldwide, causing ~750,000 deaths annually[1]

  • The results showed that there was no significant difference in the incidence rate of liver cancer between the wild-type and afp-/- mouse cohorts (Fig. 1a)

  • Oxaliplatin completely reversed the inhibitory effect of sorafenib on Fas/FADD in the combination treatment (Fig. 7h). These results suggest that the sorafenib-oxaliplatin combination has a synergistic antitumor effect on Alpha fetoprotein (AFP)-expressing HCC cells and that the AFP-mediated human antigen R (HuR)/Fas/FADD apoptotic cascade performs a direct role in this process

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Summary

Introduction

Hepatocellular carcinoma (HCC) is one of the most common malignances worldwide, causing ~750,000 deaths annually[1]. An increasing number of diagnostic and therapeutic strategies have been developed, the prognosis of HCC patients remains poor[3]. This is mainly due to the key genes and molecular mechanisms involved in HCC pathogenesis and development remaining largely unclear[3,4]. An abnormal increase in the plasma AFP level in adults is considered to be a hallmark of pathological conditions, including HCC, yolk sac tumors, and gastric carcinoma[6]. AFP is reactivated in more than 70% of HCC patients, and serum AFP has been considered the ‘goldstandard’ biomarker for clinical liver cancer diagnosis for the past several decades[5].

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