Abstract
The World Health Organisation, in its 2019 progress report on HIV, viral hepatitis and STDs indicates that 257 million people are afflicted with chronic HBV infections, of which, 1 million patients lose their lives every year due to HBV related chronic liver diseases including serious complications such as liver cirrhosis and hepatocellular carcinoma. The course of HBV infection and associated liver injury depend on several host factors, genetic variability of the virus, and the host viral interplay. The challenge of medical science is the early diagnosis/identification of the potential for development of fatal complications like liver cirrhosis and HCC so that timely medical intervention can improve the chances of survival. Currently, neither the vaccination regime nor the diagnostic methods are completely effective as reflected in the high number of annual deaths. It is evident from numerous publications that microRNAs (miRNAs) are the critical regulators of gene expression and various cellular processes like proliferation, development, differentiation, apoptosis and tumorigenesis. Expressions of these diminutive RNAs are significantly affected in cancerous tissues as a result of numerous genomic and epigenetic modifications. Exosomes are membrane-derived vesicles (30–100 nm) secreted by normal as well as malignant cells, and are present in all body fluids. They are recognized as critical molecules in intercellular communication between cells through horizontal transfer of information via their cargo, which includes selective proteins, mRNAs and miRNAs. Exosomal miRNAs are transferred to recipient cells where they can regulate target gene expression. This provides an insight into the elementary biology of cancer progression and therefore the development of therapeutic approaches. This concise review outlines various on-going research on miRNA mediated regulation of HBV pathogenesis with special emphasis on association of exosomal miRNA in advanced stage liver disease like hepatocellular carcinoma. This review also discusses the possible use of exosomal miRNAs as biomarkers in the early detection of HCC and liver cirrhosis.
Highlights
247 million people are affected with chronic Hepatitis B virus (HBV) infection [1]
Exosomal MicroRNA(Ribo nucleic acid) (miRNA) in hepatocellular carcinoma hepa-tocellular carcinoma (HCC) is the primary malignancy of liver and often develops in the background of liver cirrhosis caused by its main risk factors such as HBV or hepatitis C virus (HCV) infection, excessive alcohol uptake etc
Conclusion and future direction Several attempts have been made to investigate the propagation of chronic to advanced stage liver diseases caused by HBV
Summary
247 million people are affected with chronic Hepatitis B virus (HBV) infection [1]. Some exosomes function as pro-tumorigenic factors that can mediate intercellular communication in the tumor microenvironment via exosomal miRNA which contribute to cancer progression. Association of HBV in development of HCC are hitherto documented [58, 78–91] and mainly hepatitis B virus X protein (HBx) is known to modulate a number of cellular miRNAs that facilitate the process of hepatocarcinogenesis.
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