Morphometric analysis of hepatocellular nodular lesions in HCV cirrhosis

Imaging of Liver Tissues Using a Combination of Silver Impregnation and Low-Vacuum Scanning Electron Microscopy; A Simple Method for the High-Resolution Visualization of Reticulin Structures with Applicability to a Quantitative Analysis

Background

Low-vacuum scanning electron microscopy (LVSEM) enables the detailed three-dimensional imaging of archival tissues without special pretreatments. The clinical utility of LVSEM in the assessment of liver diseases has not yet been defined. So, we investigated the utility of LVSEM imaging in morphological assessments of normal and diseased liver tissues, with a focus on reticulin structures.

Methods

Formalin-fixed tissue samples of two normal livers and two hepatocellular carcinomas with background regenerative nodules/areas were stained with platinum blue stain or silver-impregnated using Watanabe's method and then comparatively observed under LVSEM. We also evaluated the applicability of LVSEM imaging of liver tissues to a quantitative analysis using a digital image analysis technique.

Results

Optimal high-resolution images of reticulin structures were obtained using 10-μm-thick silver-impregnated sections. Reticulin fibers were clearly observed to run dendritically around sinusoids in normal livers, and markedly increased in regenerative nodules/areas. Normal reticulin frameworks were lost in hepatocellular carcinoma, leaving a few fragments of reticulin fibers within tumors. Moreover, when a quantitative analysis was applied to these images, we successfully demonstrated a significantly higher reticulin fiber density in regenerative nodules/areas than in the normal liver (P < 0.05).

Conclusion

We not only obtained detailed three-dimensional images of reticulin structures in various liver tissues by LVSEM combined with silver impregnation but also showed their applicability to a quantitative analysis. The method presented herein may be applied to future studies for the more accurate diagnosis and better classification/risk stratification of various liver diseases.

Comparison of pulsed and oscillating gradient diffusion-weighted MRI for characterizing hepatocellular nodules in liver cirrhosis: ex vivo study in a rat model

BACKGROUND

In contrast to classical pulsed gradient diffusion-weighted MRI, oscillating gradient diffusion-weighted MR imaging (DWI) is sensitive to short distance diffusion changes at the intracellular level.

PURPOSE

To compare the diagnostic performance of pulsed and oscillating DWI for characterizing hepatocellular nodules in a rat model of hepatic cirrhosis.

STUDY TYPE

Prospective, experimental study.

ANIMAL MODEL

Cirrhosis was induced by weekly intraperitoneal injection of diethylnitrosamine in Wistar rats.

FIELD STRENGTH/SEQUENCE

Ex vivo liver MRI was performed at 7T with T₁ -weighted, T₂ -weighted, pulsed, and oscillating gradient diffusion-weighted sequences.

ASSESSMENT

Apparent diffusion coefficient from pulsed (ADC_pulsed ) and oscillating gradient (ADC_oscillating ) sequences was calculated in 82 nodules identified on the T₁ /T₂ -weighted images and on pathological examination. Two pathologists classified the nodules in three categories: benign (regenerative and low-grade dysplastic nodules), with intermediate malignancy (high-grade dysplastic nodules and early hepatocellular carcinomas) and overtly malignant (progressed hepatocellular carcinomas).

STATISTICAL TESTS

Differences between groups were assessed with Kruskal-Wallis and Mann-Whitney tests.

RESULTS

ADC, mainly ADC_oscillating , increased in the group of nodules with intermediate malignancy (ADC_pulsed : 0.75 ± 0.25 × 10^-3 mm² /s vs. 0.64 ± 0.07 × 10^-3 mm² /s in benign nodules, P = 0.025; ADC_oscillating : 0.81 ± 0.20 × 10^-3 mm² /s vs. 0.65 ± 0.13 × 10^-3 mm² /s, P = 0.0008) and ADC_pulsed decreased in the group of progressed hepatocellular carcinomas (ADC_pulsed : 0.60 ± 0.08 × 10^-3 mm² /s, P = 0.042; ADC_oscillating : 0.68 ± 0.08 × 10^-3 mm² /s, P = 0.1).

DATA CONCLUSION

ADC during hepatocarcinogenesis in rats increased in nodules with intermediate malignancy and decreased in progressed hepatocellular carcinomas. Our results suggest that oscillating gradient DWI is more sensitive to the early steps of hepatocarcinogenesis and might be useful for differentiating between high-grade dysplastic nodules / early hepatocellular carcinomas and regenerating nodules / low-grade dysplastic nodules.

LEVEL OF EVIDENCE

2 Technical Efficacy: Stage 1 J. Magn. Reson. Imaging 2020;51:1065-1074.

Selective CB2 inverse agonist JTE907 drives T cell differentiation towards a Treg cell phenotype and ameliorates inflammation in a mouse model of inflammatory bowel disease

Cannabinoids are known to possess anti-inflammatory and immunomodulatory properties, but the mechanisms involved are not fully understood. CB2 is the cannabinoid receptor that is expressed primarily on hematopoietic cells and mediates the immunoregulatory functions of cannabinoids. In order to study the effect of JTE907, a selective/inverse agonist of CB2 with anti-inflammatory properties, on the differentiation of T cell subtypes, we used an in vitro system of Th lineage-specific differentiation of naïve CD4⁺ T lymphocytes isolated from the mouse spleen. The results indicate that JTE907 was able to induce the differentiation of Th0 cells into the Treg cell phenotype, which was characterized by the expression of FoxP3, TGF-β and IL-10. P38 phosphorylation and STAT5A activation were found to mediate the signaling pathway triggered by JTE907 via the CB2 receptor in Th0 lymphocytes. In mice with DNBS-induced colitis, JTE907 treatment was able to induce an increase in the number of CD4⁺CD25⁺FoxP3⁺ cells in the lamina propria after 24 h of disease onset and reduce disease severity after 48 h. Further, longer JTE907 treatment resulted in less severe colitis even when administered orally, resulting in less body weight loss, reduction of the disease score, prevention of NF-κB activation, and reduction of the expression of adhesion molecules. Collectively, the results of this study indicate that specific signals delivered through the CB2 receptor can drive the immune response towards the Treg cell phenotype. Thus, ligands such as JTE907 may have use as potential therapeutic agents in autoimmune and inflammatory diseases.

Nitric Oxide Generated by Tumor-Associated Macrophages Is Responsible for Cancer Resistance to Cisplatin and Correlated With Syntaxin 4 and Acid Sphingomyelinase Inhibition

Tumor microenvironment is fundamental for cancer progression and chemoresistance. Among stromal cells tumor-associated macrophages (TAMs) represent the largest population of infiltrating inflammatory cells in malignant tumors, promoting their growth, invasion, and immune evasion. M2-polarized TAMs are endowed with the nitric oxide (NO)-generating enzyme inducible nitric oxide synthase (iNOS). NO has divergent effects on tumors, since it can either stimulate tumor cells growth or promote their death depending on the source of it; likewise the role of iNOS in cancer differs depending on the cell type. The role of NO generated by TAMs has not been investigated. Using different tumor models in vitro and in vivo we found that NO generated by iNOS of M2-polarized TAMs is able to protect tumor cells from apoptosis induced by the chemotherapeutic agent cisplatin (CDDP). Here, we demonstrate that the protective effect of NO depends on the inhibition of acid sphingomyelinase (A-SMase), which is activated by CDDP in a pathway involving the death receptor CD95. Mechanistic insights indicate that NO actions occur via generation of cyclic GMP and activation of protein kinase G (PKG), inducing phosphorylation of syntaxin 4 (synt4), a SNARE protein responsible for A-SMase trafficking and activation. Noteworthy, phosphorylation of synt4 at serine 78 by PKG is responsible for the proteasome-dependent degradation of synt4, which limits the CDDP-induced exposure of A-SMase to the plasma membrane of tumor cells. This inhibits the cytotoxic mechanism of CDDP reducing A-SMase-triggered apoptosis. This is the first demonstration that endogenous NO system is a key mechanism through which TAMs protect tumor cells from chemotherapeutic drug-induced apoptosis. The identification of the pathway responsible for A-SMase activity downregulation in tumors leading to chemoresistance warrants further investigations as a means to identify new anti-cancer molecules capable of specifically inhibiting synt4 degradation.

miRNA-708 functions as a tumour suppressor in hepatocellular carcinoma by targeting SMAD3

Hepatocellular carcinoma (HCC) is the most frequent subtype of primary liver cancer and the third most common cause of cancer-associated mortality worldwide. Previous studies have reported that microRNAs (miRNAs) serve key roles in the carcinogenesis and progression of HCC by regulating gene expression. The present study investigated the expression patterns, biological roles and underlying mechanisms of miRNA-708 (miR-708) in HCC. The expression levels of miR-708 in HCC tissue samples and cell lines were examined. Cell proliferation, migration and invasion assays were used to evaluate the effect of miR-708 on HCC cells. In addition, bioinformatic and western blotting analyses, and dual luciferase reporter assays were performed to investigate the direct gene target of miR-708. The results of the present study demonstrated that miR-708 expression was significantly decreased in HCC tissue samples and cell lines. In addition, the expression level of miR-708 was associated with increased HCC tumour stage. Furthermore, ectopic expression of miR-708 suppressed HCC cell proliferation, migration and invasion. The results of the present study also indicated that miR-708 targets SMAD family member 3 directly in vitro. The results of the present study indicated that miR-708 may be a novel target for future HCC therapy.

Association between underexpression of microrna-203 and clinicopathological significance in hepatocellular carcinoma tissues

Background

Although recent studies have shown the utility of miR-203 as a cancer-relevant biomarker, the validated clinical significance of miR-203 in HCC remains obscure. The aim of the present study was to evaluate the relationship between miR-203 expression and clinicopathological features in HCC patients.

Methods

MiR-203 expression in 95 formalin-fixed, paraffin embedded (FFPE) HCC tissues and their paired adjacent non-cancerous tissues was evaluated by quantitative reverse transcription polymerase chain reaction (qRT-PCR). Simultaneously, expression of miR-203 and its correlation with a variety of clinicopathological parameters and patient recurrence was analyzed.

Results

The relative level of miR-203 was 1.1651 ± 0.70378 in HCC tissues, significantly lower than its expression in the corresponding adjacent non-cancerous liver tissues (2.2408 ± 0.75351, P < 0.001). The area under curve (AUC) of low miR-203 expression to diagnose HCC was 0.85 (95 % CI: 0.796 ~ 0.904, P = 0.027) at a cut-off value 1.99 evaluated by the median expression of miR-203 in all tissues, including HCC and normal liver tissues. Expression of miR-203 was negatively correlated to metastasis (r = −0.254, P = 0.013), clinical tumor nodes metastasis (TNM) stage (r = −0.300, P = 0.003), nm23 expression (r = −0.292, P = 0.004), p21 expression (r = −0.223, P = 0.030), microvessel density (MVD)(r = −0.206, P = 0.045) and was positively correlated to cirrhosis (r = 0.487, P < 0.001). Additionally, the recurrent time of lower miR-203 expression group was 57.949 ± 4.184 months, slightly longer than that in the high expression group (54.682 ± 2.591 months), however, no significant difference was noted (Chi-square = 0.206, P = 0.650).

Conclusions

MiR-203 plays a vital role in the carcinogenesis and progression of HCC, which makes itself as a predictor for the deterioration of HCC. Furthermore, miR-203 may become a new target for molecular therapy in HCC.

Morphometric alterations, steatosis, fibrosis and active caspase-3 detection in carbamate bendiocarb treated rabbit liver

Increasing use of pesticides all over the world makes it necessary to reveal the toxic risk in populations of nontargeted organisms. Bendiocarb is one of the 12 insecticides recommended by the World Health Organization for use in malaria control in Africa, and is used against a variety of insects. The liver has an important role in its process of detoxication and excretion. In our experiment 56 adult rabbits of breed HY+, 28 males and 28 females were used. Animals were divided into groups (control, days 10, 20, 30 of bendiocarb administration). The presence of many binucleated hepatocytes, the highest number of liver cells and their decreased size at 10 day after bendiocarb administration was observed as an evidence of the hepatic regeneration. After the long-term treatment pronounced changes were presented such as vacuolization and dilatation of hepatocytes, dilatation of sinusoids between hepatocytes, and focal infiltration of inflammatory cells. Numerous cells with caspase-3 activity were present throughout the organ, most commonly around the portal tract and close to the central vein. Short and long-term bendiocarb treatment showed the central vein thickened rim with increased deposition of collagen, spreading of collagen fibers into the perisinusoidal, and pericellular space surrounding the central veins, and septal fibrosis extended from the portal tract. Subsequently, presence of the lipid vacuoles both in the liver parenchyma and inner of the hepatocytes were observed. These results suggest that bendiocarb treatment leads to increased cell death, liver perisinusoidal fibrosis, and steatosis, especially during the long-term administration.

Decreased expression and clinical significance of miR-148a in hepatocellular carcinoma tissues

Background

Aberrant expression of microRNA-148a (miR-148a) has been reported in several types of malignancies. However, its expression and clinicopathological significance in hepatocellular carcinoma (HCC) has not been entirely clarified. Our objective was to investigate the clinicopathological contribution of the miR-148a expression in HCC formalin-fixed paraffin-embedded (FFPE) tissues.

Methods

Eighty-nine HCC and their para-cancerous liver tissues were recruited. Total mRNA including miRNA was isolated and miR-148a expression was determined by using real time RT-qPCR. Furthermore, the relationship between the miR-148a level and clinicopathological features was explored.

Results

Significantly lower miR-148a expression in HCC tissues was observed than that in adjacent noncancerous hepatic tissues. miR-148a expression was also correlated to clinical TNM stage, metastasis, status of capsular infiltration and numbers of tumor nodes.

Conclusions

Underexpression of miR-148a might be associated with HCC tumorigenesis and deterioration of HCC. miR-148a might act as a suppressor miRNA of HCC and it therefore has a potential role in prognosis of HCC patients.

Synergistic effect of MiR-146a mimic and cetuximab on hepatocellular carcinoma cells

Previously, we found that the expression of microRNA-146a (miR-146a) was downregulated in hepatocellular carcinoma (HCC) formalin-fixed paraffin-embedded (FFPE) tissues compared to the adjacent noncancerous hepatic tissues. In the current study, we have explored the in vitro effect of miR-146a on the malignant phenotypes of HCC cells. MiR-146a mimic could suppress cell growth and increase cellular apoptosis in HCC cell lines HepG2, HepB3, and SNU449, as assessed by spectrophotometry, fluorimetry, and fluorescence microscopy, respectively. Furthermore, western blot showed that miR-146a mimic downregulated EGFR, ERK1/2, and stat5 signalings. These effects were less potent compared to that of a siRNA targeting EGFR, a known target gene of miR-146a. Moreover, miR-146a mimic could enhance the cell growth inhibition and apoptosis induction impact of various EGFR targeting agents. The most potent combination was miR-146a mimic with cetuximab, presenting a synergistic effect. In conclusion, miR-146a plays a vital role in the cell growth and apoptosis of HCC cells and inducing miR-146a level might be a critical targeted molecular therapy strategy for HCC.

Expression and clinicopathological significance of miR-146a in hepatocellular carcinoma tissues

BACKGROUND

Aberrant expression of microRNA-146a (miR-146a) has been found in several classes of cancers. However, its expression and clinicopathological contribution in hepatocellular carcinoma (HCC) has not been fully elucidated.

OBJECTIVE

To explore the clinicopathological significance of the miR-146a level in HCC formalin-fixed paraffin-embedded (FFPE) tissue.

METHODS

Eighty-five HCC samples and their para-cancerous normal liver tissues were collected. Total mRNA including miRNA was extracted, and miR-146a expression was determined using real-time RT-PCR. Furthermore, the correlation between the miR-146a expression and clinicopathological parameters was investigated.

RESULTS

MicroRNA-146a expression in HCC tissues was lower compared with that in adjacent non-cancerous hepatic tissues. MicroRNA-146a expression was also related to clinical TNM stage, metastasis, portal vein tumor embolus, and number of tumor nodes.

CONCLUSIONS

Down-regulation of miR-146a is related to HCC carcinogenesis and deterioration of HCC. MicroRNA-146a may act as a suppressor miRNA of HCC, and it is therefore a potential prognostic biomarker for HCC patients.

Increased miR-221 expression in hepatocellular carcinoma tissues and its role in enhancing cell growth and inhibiting apoptosis in vitro

Background

MiR-221 is over-expressed in human hepatocellular carcinoma (HCC), but its clinical significance and function in HCC remains uncertain. The aim of the study was to investigate the relationship between miR-221 overexpression and clinicopathological parameters in HCC formalin-fixed paraffin-embedded (FFPE) tissues, and the effect of miR-221 inhibitor and mimic on different HCC cell lines in vitro.

Methods

MiR-221 expression was detected using real time RT-qPCR in FFPE HCC and the adjacent noncancerous liver tissues. The relationship between miR-221 level and clinicopathological features was also analyzed. Furthermore, miR-221 inhibitor and mimic were transfected into HCC cell lines HepB3, HepG2 and SNU449. The effects of miR-221 on cell growth, cell cycle, caspase activity and apoptosis were also investigated by spectrophotometry, fluorimetry, fluorescence microscopy and flow cytometry, respectively.

Results

The relative expression of miR-221 in clinical TNM stages III and IV was significantly higher than that in the stages I and II. The miR-221 level was also upregulated in the metastatic group compared to the nonmetastatic group. Furthermore, miR-221 over-expression was related to the status of tumor capsular infiltration in HCC clinical samples. Functionally, cell growth was inhibited, cell cycle was arrested in G1/S-phase and apoptosis was increased by miR-221 inhibitor in vitro. Likewise, miR-221 mimic accelerated the cell growth.

Conclusions

Expression of miR-221 in FFPE tissues could provide predictive significance for prognosis of HCC patients. Moreover, miR-221 inhibitor could be useful to suppress proliferation and induce apoptosis in HCC cells. Thus miR-221 might be a critical targeted therapy strategy for HCC.

Definition of diethylnitrosamine-induced rat hepatic precancerous lesions with atypia index

AIM: To define diethylnitrosamine-induced hepatic precancerous lesions with atypia index in rats.

METHODS: After normalization of the body weight, 100 male Wistar rats were equally and randomly divided into five groups and were intraperitoneally injected with different doses of diethylnitrosamine in normal saline (0, 25, 50, 75, 100 mg/kg) twice weekly. The rats in each group were further divided into 10 subgroups with end-points ranging from d00 to d126 with an interval of 14 days. Liver samples were fixed, sectioned, and stained with hematoxylin and eosin. After being evaluated pathologically, the volume ratios of portal triad (R₁), hepatic cord (R₂) and hepatic nucleus (R₃) were obtained under an Olympus microscope with 10-, 20-, and 40-amplification, respectively, by use of Image-Pro Plus software. Hepatic mitotic figures were counted under high magnification. The atypia index of hepatocytes was calculated as the volume ratio of nucleus to cytoplasm in precancerous lesions using the formula [(1-R₁)^-1∙(R₂)^-1∙(R₃)]. By using Graph Pad Prism version 4 for Windows, the half effective durations and the area under curve of the atypia indexes were regressed in Sigmoidal time-response (variable slope) from the logarithm of end-point hours [11.4 + Time (d) ×24 h/d] for each of 5 doses, so did the half effective doses of the area under curves from the logarithm of dosages [10 + Dose (mg/kg) ×1000 (μg/kg)]. The atypia indexes were regressed linearly with the mitotic counts to confirm their specificity in predicting hepatic carcinogenesis.

RESULTS: From the atypia index of hepatocytes (corrected volume ratio of nucleus to cytoplasm), the half effective durations of diethylnitrosamine at 0, 25, 50, 75, and 100 mg/kg to induce hepatic precancerous lesions were 70 347, 1 734, 1 536, 1 530 and 1 183 h, respectively. The areas under curves were 0.0064, 0.0084, 0.0123, 0.0165 and 0.0167 [(atypia index) × log(h)], respectively. From the area under curve, the half effective dose of diethylnitrosamine to induce hepatic precancerous lesions was 48.225 mg/kg. The atypia indexes in rats treated with 50 mg/kg diethylnitrosamine correlated positively with mitotic counts in hepatic precancerous lesions (y = 0.0023x-0.0056, r = 0.9217, n = 10, P < 0.01).

CONCLUSION: The atypia index might be used to define hepatic precancerous lesions. A rat model of hepatic precancerous lesions could be replicated by intraperitoneal injection of diethylnitrosamine at a dose of 48.225 mg/kg twice a week for 9 wk. The specificity of the model to predict hepatic carcinogenesis can be confirmed with mitotic counts in hepatic precancerous lesions.