Hepatocellular carcinoma (HCC) is the most common hepatic malignancy and the third leading cause of cancer related deaths. Previous studies have implicated bile acids in pathogenesis of HCC but the mechanisms are not known. We investigated the mechanisms of bile acid‐mediated promotion of HCC using a diethylnitrosamine (DEN)‐mediated initiation‐cholic acid (CA)‐induced tumor promotion protocol in mice. The data show that 0.2% CA treatment resulted in 3‐fold increase in number and size of DEN‐induced liver tumors. All tumors observed in DEN‐treated mice were well‐differentiated HCCs. Microarray based global gene expression studies combined with Ingenuity Pathway Analysis revealed NF‐κB pathway as the main signaling pathways activated in the DEN‐treated 0.2% CA‐fed livers. Further studies showed significantly higher TNFα, IL‐1β, MCP‐1 mRNA, a significant increase in total and phosphorylated‐p65 and phosphorylated IκBa (degradation form) and higher EGR1 mRNA and protein in livers of DEN‐treated 0.2% CA‐fed mice. Interestingly, total bile acid quantification revealed increase in hepatic and serum bile acids in both DEN‐treated and DEN‐treated 0.2% CA‐fed mice, which was higher in the latter group. Finally, quantification of total serum bile acids in normal, cirrhotic and HCC human samples revealed increased bile acids in serum of cirrhotic and HCC patients. Taken together, these data indicate that bile acids are mechanistically involved pathogenesis of HCC and may promote HCC formation via activation of inflammatory signaling.
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