Journal
FRONTIERS IN BIOSCIENCE-LANDMARK
Volume 7, Issue -, Pages D204-D218Publisher
FRONTIERS IN BIOSCIENCE INC
DOI: 10.2741/okuno
Keywords
hepatocellular carcinoma; retinoic acid; retinol-binding protein; cellular retinol-binding protein; cellular retinoic acid-binding protein; retinoic acid receptor; retinoid X receptor; all-trans; Ra response element; response element; hepatic parenchymal cell; hepatic stellate cell; extracellular matrix; transforming growth factor-beta; plasminogen activator; fibroblast growth factor; smooth muscle actin; Pa inhibitor-1; lipopolysaccharide; hepatitis B virus; hepatitis C virus; interferon; mitogen-activated protein kinase; acute promyelocyte leukemia; cholangiocellular carcinoma; dimethylnitrosamine; lectin-reactive alpha-fetoprotein fraction; alcohol dehydrogenase; aldehyde dehydrogenase; high performance liquid chromatography; urokinase; review
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Pathobiological functions and metabolism of retinoids (vitamin A and its derivatives) in liver fibrosis and hepatocellular carcinoma (HCC) are discussed in the present review. Retinoic acid (RA, active metabolite) exacerbates liver fibrosis that is not accompanied by hepatic necroinflammation, in which RA acts directly on hepatic stellate cells (HSCs); RA enhances plasminogen activator/plasmin levels and thereby induces proteolytic activation of latent transforming growth factor-beta (TGF-beta), a strong fibrogenic cytokine, resulting in enhanced collagen production. We have developed a protease inhibitor, camostat mesilate, that suppresses TGF-beta ctivation and thereby inhibits the transformation of HSCs, leading to reduced matrix production by the cells. The compound is effective not only in preventing but also in reducing hepatic fibrosis in rats when administered orally. HCC is refractory to RA due to its local depletion in the tumors and also due to malfunction of its nuclear receptor, retinoid X receptor-alpha (RXRalpha) Oral supplementation of a synthetic retinoid named acyclic retinoid led to the disappearance of serum lectin-reactive fetoprotein (AFP-L3) and subsequently suppressed posttherapeutic recurrence of HCC in cirrhotic patients. These results suggest eradication of AFP-L3-producing latent malignant clones from the liver by the retinoid. We propose the concept of clonal deletion therapy for cancer chemoprevention, a new category of cancer chemotherapy.
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