Abstract

Obesity and related metabolic abnormalities play a key role in liver carcinogenesis. Non-alcoholic steatohepatitis (NASH), which is often complicated with obesity and diabetes mellitus, is associated with the development of hepatocellular carcinoma (HCC). Sodium alginate (SA), which is extracted from brown seaweeds, is marketed as a weight loss supplement because of its high viscosity and gelling properties. In the present study, we examined the effects of SA on the progression of NASH and related liver carcinogenesis in monosodium glutamate (MSG)-treated mice, which show obesity, diabetes mellitus, and NASH-like histopathological changes. Male MSG-mice were intraperitoneally injected with diethylnitrosamine at 2 weeks of age, and, thereafter, they received a basal diet containing high- or low-molecular-weight SA throughout the experiment (16 weeks). At sacrifice, control MSG-treated mice fed the basal-diet showed significant obesity, hyperinsulinemia, steatosis and hepatic tumor development. SA administration suppressed body weight gain; improved insulin sensitivity, hyperinsulinemia, and hyperleptinemia; attenuated inflammation in the liver and white adipose tissue; and inhibited hepatic lipogenesis and progression of NASH. SA also reduced oxidative stress and increased anti-oxidant enzyme levels in the liver. Development of hepatic tumors, including liver cell adenoma and HCC, and hepatic pre-neoplastic lesions was significantly inhibited by SA supplementation. In conclusion, oral SA supplementation improves liver steatosis, insulin resistance, chronic inflammation, and oxidative stress, preventing the development of liver tumorigenesis in obese and diabetic mice. SA may have ability to suppress steatosis-related liver carcinogenesis in obese and diabetic subjects.

Highlights

  • Hepatocellular carcinoma (HCC) is a serious healthcare problem worldwide because of its increasing morbidity and high mortality

  • To investigate the preventive effects of Sodium alginate (SA) on the development of obesity-related liver carcinogenesis, monosodium glutamate (MSG)-treated mice were selected for the present study because they show significant obesity, hyperinsulinemia, and non-alcoholic steatohepatitis (NASH)-like histology, which is virtually undistinguishable from those in humans

  • Several rodent studies have revealed that intervention using anti-metabolic agents may be an effective strategy for preventing obesity- and NASH-related liver carcinogenesis [10, 11]

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Summary

Introduction

Hepatocellular carcinoma (HCC) is a serious healthcare problem worldwide because of its increasing morbidity and high mortality. Chronic inflammation of the liver and subsequent cirrhosis are the strongest risk factors for HCC development. Recent evidence indicates that obesity and related metabolic abnormalities, especially diabetes mellitus and insulin resistance, increase the risk of HCC [1,2,3]. Increased levels of oxidative stress and aberrant lipogenesis in the liver, both of which are significantly linked to obesity and metabolic syndrome, are dominantly observed during liver carcinogenesis and HCC progression [5, 6]. Non-alcoholic fatty liver disease (NAFLD) is a hepatic manifestation of the metabolic syndrome, and a proportion of patients with this disease can show progression to non-alcoholic steatohepatitis (NASH) and the risk of developing cirrhosis and HCC [7]. In addition to lifestyle modification to reduce body weight, active pharmacotherapy is considered necessary for the management of patients with NASH, especially those who have the metabolic syndrome

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