Association of hepatic oxidative stress and iron dysregulation with HCC development after interferon therapy in chronic hepatitis C

Shintaro Nanba, Fusao Ikeda, Nobuyuki Baba, Koichi Takaguchi, Tomonori Senoh, Takuya Nagano, Hiroyuki Seki, Yasuto Takeuchi, Yuki Moritou, Tetsuya Yasunaka, Hideki Ohnishi, Yasuhiro Miyake, Akinobu Takaki, Kazuhiro Nouso, Yoshiaki Iwasaki, Kazuhide Yamamoto

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Abstract

Background Oxidative stress may play pathogenic roles in the mechanisms underlying chronic hepatitis C (CHC). The impact of excessive oxidative stress and iron dysregulation on the development of hepatocellular carcinoma (HCC) after interferon therapy has not been established. Methods We investigated the impact of oxidative stress and iron deposition on HCC development after therapy with pegylated interferon (PegIFN)+ribavirin in CHC patients. Systemic and intracellular iron homeostasis was evaluated in liver tissues, peripheral blood mononuclear cells and sera. Results Of 203 patients enrolled, 13 developed HCC during the 5.6-year follow-up. High hepatic 8-hydroxy-2-deoxyguanosine (8-OHdG) levels were significantly associated with HCC development in multivariate analysis (p=0.0012) which was also significantly correlated with severity of hepatic iron deposition before therapy (p<0.0001). Systemic and intracellular iron regulators of hepcidin and F-box and leucine-rich repeat protein 5 (FBXL5) expression levels were significantly suppressed in CHC patients (p=0.0032 and p=0.016, respectively) despite their significantly higher levels of serum iron and ferritin compared with controls. However, intracellular iron regulators of FBXL5 and iron regulatory proteins were regulated in balance with hepatic iron deposition. Significant correlations were observed among IL-6, bone morphogenetic protein 6, hepcidin and ferroportin, as regards systemic iron regulation. Conclusions Measurement of hepatic oxidative stress before antiviral therapy is useful for the prediction of HCC development after interferon therapy. Low baseline levels of the intracellular iron regulators of FBXL5 in addition to a suppressed hepcidin level might be associated with severe hepatic iron deposition in CHC patients.

Original languageEnglish
Pages (from-to)226-233
Number of pages8
JournalJournal of Clinical Pathology
Volume69
Issue number3
DOIs
Publication statusPublished - Mar 2016

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ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Nanba, S., Ikeda, F., Baba, N., Takaguchi, K., Senoh, T., Nagano, T., Seki, H., Takeuchi, Y., Moritou, Y., Yasunaka, T., Ohnishi, H., Miyake, Y., Takaki, A., Nouso, K., Iwasaki, Y., & Yamamoto, K. (2016). Association of hepatic oxidative stress and iron dysregulation with HCC development after interferon therapy in chronic hepatitis C. Journal of Clinical Pathology, 69(3), 226-233. https://doi.org/10.1136/jclinpath-2015-203215