Background
The development of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) is polyfactorial, including cellular signaling pathway changes and cell cycle alteration, together with an inflammatory and cytokine responses that are driven by viral antigens [
1], including HBV mutant variants. Among the HBV mutant variants, mutations in the S protein are common in patients and are related to HCC [
2]. A previous study demonstrated that preS mutants were associated with an ascending risk (3.77-fold) of HCC and the forecast value of these mutants in the development of HCC had been defined [
3,
4]. PreS2-defective viruses mutated in the promoter region or 5’-terminal regions are the main HBV variants and are more commonly associated with HCC. There have been few reports on the relationship between C-terminally truncated middle proteins and HCC, especially in vitro validation reports. Notably, preS/S sequences deleted at the 3’-end that produce functionally active C-terminally truncated middle surface protein (MHBSt) have been found in many HBV DNA positive HCC patients, and protein kinase C (PKC)-dependent activation of the c-Raf-1/MEK/Erk2 signaling pathway was triggered by MHBSt retained in the endoplasmic reticulum (ER) in MHBSt transgenic mice and hepatoma cells, which, leading to regulation of AP-1 and enhanced proliferative activity of hepatocytes [
5]. MHBSt act as a transcriptional activator to activating the hTERT promoter in hTERT highly expressed preS2-positive human HCC samples, leading to upregulated telomerase activity and promoting HCC development [
6]. MHBSt
167 was one of the first reported mutations of S-truncated proteins, and MHBst
167/HBx could induce nuclear factor-κB (NF-κB) activation via the PKC/ERK pathway in renal tubular cells [
7,
8]. The transcriptional activity of the c-Myc promoter could be upregulated by MHBst
167, as well as transcription and translation of c‑Myc, which is a proto‑oncogene, in HepG2 cells [
9]. The relationship between MHBSt
167 and HCC is unclear, and the mechanism remains to be determined.
Autophagy is a fundamental process of cells which eliminates damaged intracellular organelles and misfolded proteins to maintain cellular homeostasis [
10]. The role of autophagy in the liver is complex. The liver requires autophagy to remove excessive aggregated proteins, accumulated lipids, and impaired mitochondria to prevent excessive production of reactive oxygen species (ROS), which leads to oxidative stress in the ER [
11]. Unresolved oxidative stress, persistent inflammation, and viral infections are the most commonly identified risk factors for HCC development. ER-induced autophagy plays a protective role against both initial and persistent liver injury and a vital role in the development and growth of hepatic tumor cells in an inflammatory environment [
12,
13]. MHBSt can be retained in the ER and trigger ER stress [
5]. The antioxidants N-acetyl-L-cysteine (NAC) and pyrimidine dithiocarbamate (PDTC) can block host gene induction by MHBSt, indicating that MHBSt can induce oxidative stress, which is a risk factor for HCC development [
8]. Based on the above literature, we hypothesized that MHBSt could induce autophagy to promote HCC development.
Most cases (80–90%) of liver cancer arise in the setting of a chronically inflamed liver (due to hepatitis B, hepatitis C, or alcoholic and nonalcoholic liver diseases) or liver fibrosis/cirrhosis, HCC can be considered a prototype of inflammation-derived cancer arising from chronic liver injury [
14]. In chronic liver disease, innate immune response plays a critical role in persistent inflammation, fibrosis/cirrhosis, and the persistently accelerated turnover of liver cells provides the basis for the occurrence of liver cancer. NF-κB is well accepted as a central mediator that regulates immune and inflammatory responses [
15]. MHBSt is produced by nonintegrated viral variants to cope with the selective pressure of the host immune response [
16]. MHBSt can cause DNA binding activity of NF-κB [
8]. These results indicate that the immune response may be associated with MHBSt. Autophagy participates in most intracellular stress response pathways, including immune response and inflammation control pathways [
17]. These interactions act both at changing the autophagy level and regulating direct interactions between autophagy proteins and immune signaling molecules [
18]. Autophagy pathways/proteins, immunity and inflammation can be interregulated through positive and negative feedback [
19], suggesting that MHBSt-induced autophagy and the immune response may interact reciprocally to regulate HCC development.
In the present study, MHBSt167 was expressed in the L02 cell line, and the oncogenicity of MHBSt167 was analyzed. The expression of autophagy-related proteins and the activation of NF-κB were examined. Autophagy inhibitors were used to analyze whether autophagy and the immune response induced by MHBSt167 interact with each other to regulate HCC development.
Materials and methods
Chemicals and reagents
Dulbecco’s modified Eagle’s medium (DMEM), fetal bovine serum (FBS), Lipofectamine™ 3000 transfection reagent, TRIzol reagent, LysoTracker Red and the high capacity cDNA reverse transcription kit were purchased from Thermo Fisher Scientific (Waltham, MA, USA). Rapa and 3-MA were obtained from Sigma-Aldrich Co. (St Louis, MO, USA). CQ and BAY-11-7082 were obtained from Selleck (Houston, Texas, USA). Mouse anti-human monoclonal antibodies against PreS2/S, β-actin, and histone 3 were purchased from Abcam (C ambridge, UK). Anti-human monoclonal antibodies against LC3, Beclin-1, SQSTM/P62, NF-κB, p-NF-κB/p65, IκB, p-IκB, Vimentin, E-cadherin and Protein Disulfide Isomerase (PDI) were purchased from Cell Signaling Technology (Boston, MA, USA). The Immobilon Western Chemiluminescent HRP substrate was purchased from EMD Millipore (Billerica, MA, USA). The cell counting kit-8 was purchased from Beyotime (Shanghai, China). Alexa Fluor 488-conjugated goat anti-mouse IgG (H + L), Alexa Fluor 594-conjugated goat anti-rabbit IgG (H + L), DyLight 405-labeled goat anti-mouse IgG (H + L) and Alexa Fluor 488-conjugated goat anti-rabbit IgG (H + L) were purchased from ZSGB-BIO (Beijing, China). Propidium Iodide (PI)/RNase staining buffer was purchased from BD Biosciences (Franklin, NJ, USA).
Plasmid construction
To construct the pcDNA3.1-MHBSt167 and pcDNA3.1-MHBS plasmids, the genes were amplified from the Phy106 + wta plasmid (HBV adr genome). The primers were as follows: MHBSt167 and MHBS forward primer, 5’GAATTCATGCAGTGGAACTCCACAAC3’; MHBSt167 reverse primer, 5’CTGCAGCTATCCTGGAAGTAGAGGACAAAC3’, and MHBS reverse primer, 5’CTGCAGTTAAATGTATACCCAAAGAAAATTGG3’. These two ligated vectors were confirmed by DNA sequence analysis. The primers for IFNα, IFNβ and IL-1α were purchased form QIAGEN (Dusseldorf, Germany). The GFP-LC3 and mRFP-GFP-LC3 plasmids were purchased from Addgene.
Cell culture
The human hepatocyte cell line L02 was obtained from the Chinese Academy of Sciences Cell Bank (Shanghai, China) and cultured in DMEM with 10% FBS and 1% penicillin–streptomycin (10,000 U/mL penicillin and 10 mg/mL streptomycin) at 37 °C in an incubator containing 5% CO2 and moderate amount of water vapor. Change the medium every two days, and cell passage or subsequent experiments was performed when they grew to 80% density.
cDNA synthesis and PCR
After being harvest, cells were washed with ice-cold PBS (Phosphate Buffer Saline) for twice in plates, and TRIzol reagent was added into plates to extract total RNA according to the manufacturer’s instructions. RNA concentration and purity were measured using a UV spectrophotometer (Eppendorf, Hamburg, Germany). Synthesize cDNA was performed by using the high capacity cDNA reverse transcription kit according to the manufacturer’s instructions. Then, PCR was followed. The primers used for PCR were the same as those used to construct the pcDNA3.1-MHBSt167 and pcDNA3.1-MHBS plasmids.
Immunoblotting
After being harvest, cells were washed with ice-cold PBS for twice and total protein was extract by RIPA lysis buffer according standard procedure. The protein concentration was determined by bicinchoninic acid analysis according to the manufacturer’s instructions. Homogenized protein extract and were separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and then transferred onto nitrocellulose membranes. Blocking the membranes with 5% skim milk for 2 h and then incubated with primary antibodies diluted at a ratio of 1:1,000 with 3% skim milk overnight at 4 °C. Washing the membranes with Tris-buffered saline with Tween-20 for 3 times to remove the unbound primary reactance, and then the membranes were incubated with HRP-conjugated secondary antibodies at room temperature for 2 h. An enhanced chemiluminescent kit was used to visualize the immunoreactive proteins according to the manufacturer’s protocol.
Cell counting kit-8 (CCK-8) assay
CCK-8 assays were performed according to the manufacturer’s instructions. Briefly, L02 cells were seeded in 96-well plates at 2 × 104 cells/well and transfected with the MHBS and MHBSt167 expression plasmids. Before harvest, CCK-8 solution was added into each well and incubated for 2 h at 37 °C. Finally, the absorbance of the lysates was measured at 570 nm using a microplate reader.
Cell cycle analysis
PI/RNase staining buffer was used to analyze the cell cycle as previously reported. After L02 cells were transfected with pcDNA3.1-MHBSt167 and pcDNA3.1-MHBS plasmids for 48 h, the cells were washed with cold PBS, harvested, fixed with 70% ethanol at − 20 °C for 1 h, and centrifuged at 1000 g for 10 min at 4 °C. The cells were then washed with cold PBS and resuspended in PI/RNase staining buffer for 15 min in the dark, followed by FCM analysis.
Colony formation assay is an important method to detect cell proliferation ability. In 6-well plate, when a single cell proliferates for more than 50 cells (about 7–14 d), they become a clone with a size between 0.3 and 1.0 mm. The proliferation ability of L02 cells was monitored by plate cloning assay. Cell suspensions (2000 cells/ well) were prepared and seeded in 6-well plate, which were then transfected with Vector, MHBS and MHBSt167 for 7–14 d. The visible cell colonies were fixed with 4% paraformaldehyde and stained with crystal violet solution for 15 min. Typical colony images were recorded with camera and Microscopic imaging system, and the number of cell colonies was counted.
Immunofluorescence and confocal microscopy
Cells were transfected with MHBSt167 and MHBS expression plasmids using Lipofectamine 3000. Forty-eight hours after transfection, LysoTracker Red was added to the medium and incubated for 2 h at 37 °C. The cells were washed with PBS, and then fixed in 4% paraformaldehyde, and permeabilized with 1% Triton X-100. The cells were washed with PBS three times. For immunofluorescence analysis, the cells were blocked with FBS for 30 min and incubated with the appropriate primary antibodies and fluorescently labeled secondary antibodies, followed by fluorescently-labeled secondary antibodies. Then, DAPI (Sigma) was included in the final wash at a final concentration of 0.1 μg/mL to stain the nuclei. The images were visualized with confocal microscopy. The resulting images were deconvolved with Delta vision software.
Statistical analysis
The data are presented as the mean ± standard error mean. Experiments were repeated at least two times. A two-way chi-square test was used for cell cycle data analysis. Student’s t-test was used for the rest of data analysis. All data analysis was performed by using GraphPad Prism7 software. A value of P < 0.05 and P < 0.01 were considered to be statistically significant.
Discussion
The present study showed that MHBSt167 could promote HCC development by promoting cell proliferation and EMT and accelerating cell cycle progression from S phase to G2/M phase. These findings are consistent with the results of an epidemiologic study and a report showing that MHBSt167 can enhance the proliferative activity of hepatocytes and upregulate oncogene expression. In addition, the present study showed that MHBSt167-induced autophagy and the NF-κB mediated innate immune response were related to HCC development.
It has reported that the preS mutants can activate both endoplasmic reticulum (ER) stress-dependent and ER stress-independent signals [
5]. In no ER stress dependent manner, the preS mutants can additionally promote hepatocyte proliferation by inducing an ER stress-independent activation of a signal transduction pathway that involves the Jun activation domain-binding protein 1 (JAB1), the cyclin-dependent kinase (Cdk) inhibitor p27 [
21]. After p27 inhibition, activation of CdK2 was upregulated and binding to Cyclins A to promote phase S to G2/M to inducing cell proliferation [
22,
23]. In ER stress dependent manner, ER stress resulted in the activation of NF-κB and the calcium-dependent protease μ-calpain. The activation of μ-calpain in turn causes the cleavage of cyclin A resulting in an N-terminus-truncated product and promoting the binding of Cyclin A and CdK2 to accelerate cell cycle transition from S to G2/M [
24]. PreS activate NF-κB signaling pathway to upregulate cyclooxygenase-2 (COX-2), vascular endothelial growth factor (VEGF) and human telomerase reverse transcriptase (hTERT) expression [
5]. In addition, a truncated form of preS2 protein appears to be able to directly interact with a preS2-responsive DNA region and can activate the hTERT promoter, resulting in the upregulation of telomerase activity and in the promotion of HCC development. In this study, EMT and accelerated cell cycle transition from S to G2/M was induced by MHBSt
167, we concluded that MHBSt
167 contributes to HCC. In addition, MHBSt
167 was retained within cells and the co-location of MHBSt
167 and ER markers was significantly increased, which indicated that MHBSt
167 induced HCC in ER stress dependent manner.
It has been reported that about 11% of secreted proteins and 20% of single-point or multipoint transmembrane proteins are inserted into the ER lumen by N-terminal signal sequences [
25],
26. Misfolded or mutant proteins accumulate in ER and Ca
2+ levels change could induce ER stress [
27]. MHBS is inserted into the ER by three transmembrane structures, and the C-terminus is inserted into the ER membrane. However, the C-terminus of MHBSt
167 is untethered in the ER, inducing ER stress [
8]. ER stress triggers the unfolded protein response (UPR) to counteract the deleterious consequences of ER stress and restore ER homeostasis [
28]. Autophagy is thought to be mainly related to UPR, promoting the survival of stress cells by removing unfolded proteins. The UPR and autophagy are two different programs related to cellular homeostasis, either working independently or working in cooperation to protect cell physiology from multiple stressors. In this study, MHBSt
167 significantly increased autophagic flux. Autophagy in liver participates in functional biosynthesis and damaged organelles recycling [
29]. Autophagy also plays an important role in Hepatic pathologic changes and tumor development. Abnormal autophagy results in oxidative stress, leading to abnormal gene expression, and could transform the cells, promoting tumorigenesis [
30]. Autophagy acts as an anticancer mechanism, inhibiting the malignant transformation of normal cells into cancer cells [
31]. On the other hand, autophagy is also implicated in different stages of cancer development and metastasis. The survival of fast-growing tumors is particularly correlated with their autophagic activity. The precise role of autophagy in HCC is unclear and has not been fully elucidated. The results of this study showed that the inhibition of autophagy could abolish MHBSt
167-induced L02 cell proliferation and the cell cycle. This finding indicated that MHBSt
167-induced autophagy could promote HCC development.
C-terminally truncated surface proteins are produced by the chromosomal integrated HBV sequences and nonintegrated viral variants, which formed by the selective pressure of the host immune response and/or antiviral treatments [
16,
32]. This finding suggests that MHBSt
167 may be related to the host immune response. To verify this hypothesis, NF-κB activation and the expression of downstream cytokines was examined. The results revealed significantly enhanced translocation of p-NF-κB/p65 from the cytoplasm to the nucleus in the presence of MHBSt
167, and the expression of IFN-α, IFN-β and IL-1α was upregulated, indicating that MHBSt
167 could induce an immune response. Cirrhosis and chronic inflammation are highly likely to develop into liver cancer, and its immunological mechanisms had been deciphered [
33]. During the progression of liver diseases, immune and inflammatory responses are considered driving factors and prerequisites for liver cancer [
34]. Factors that drive inflammation to develop into live cancer include abnormal regeneration after hepatocyte death, fibrosis, or angiogenesis [
35]. However, malignant tumors also produce an intrinsic inflammatory response, which in some cases is beneficial for the antitumor response [
36,
37]. BAY-11-7082, an NF-κB inhibitor, was used to verify whether the MHBSt
167-induced immune response was related to HCC. The results showed that MHBSt
167 enhanced cell proliferation and cell cycle, which could be blocked by BAY-11-7082 treatment. Taken together, our results indicate that MHBSt
167 can promote HCC development by inducing the immune response.
It has been reported that a large number of immune-related signaling molecules can regulate autophagy, which suggests the central importance of autophagy in immunity. Autophagy is regulated by different immune-related signaling molecules, including pathogen-recognition receptors, pathogen receptors, downstream immunity-related GTPases, inhibitor of NF-κB (IKK) and NF-κB [
38]. On the other hand, autophagy-related proteins can regulate innate immune signaling pathways. Type I IFN production was upregulated by autophagy-related proteins in dendritic cells while the RIG-I-like receptor-mediated induction of type I IFN production was negatively regulated by these proteins [
39‐
41]. The autophagy protein ATG9A negatively regulates the activation of STING to inhibit the efficient activation of type I IFN and pro-inflammatory cytokine production in response to stimulatory DNA [
42]. The innate immune signal molecule has its unique corresponding autophagy protein. The autophagy pathway and/or proteins also play decisive roles in regulating inflammatory responses. In autophagy-deficient cells, p62 expression was increased and accumulated in cells, leading to the activation of the pro-inflammatory transcription factor NF-κB through a mechanism involving TRAF6 oligomerization [
43]. In hepatocytes deficient in the autophagy protein Atg7, the accumulation of p62 leads to enhanced activation of the stress-responsive transcription factor NRF2 and liver injury [
38]. Melanoma patients and mouse models have upregulated autophagy level, tumor growth was decreased in myeloid cells and antitumor immune response was induced in vivo by inhibiting autophagy. In myeloid-derived suppressor cells, expression of membrane-associated RING-CH1 E3 ubiquitin ligase was decreased by inhibiting autophagy, leading to enhanced surface expression of MHC-II and followed by tumor-specific CD4 T cells expansion [
44]. Expression level and release of the cytokine CCL5 were increased by inhibition of BECN1 via the MAPK8/JNK-JUN/c-Jun signaling pathway, resulting in tumor growth inhibition and massive natural killer cell infiltration into the tumor microenvironment (
45). Overall, these findings emphasize the importance of autophagy in the tumor immune response. To explore the relationship between autophagy and the immune response induced by MHBSt
167, 3-MA and ATG5 siRNA was used to inhibit autophagy. In the present study, MHBSt
167 induced an immune response, as evidenced by the enhanced translocation of p-NF-κB/p65 from the cytoplasm to the nucleus, and MHBSt
167-induced p-NF-κB/p65 nuclear translocation was significantly inhibited after autophagy was inhibited with 3-MA and siATG5. It is incongruent with the findings that autophagy activation by rapamycin itself does not induce any NF-κB activation nor oncogenic phenotype in L02 cells. We speculate that autophagy activation was not the only pathway related to MHBSt
167-mediated NF-κB activation and subsequent oncogenic phenotype. The other pathway activated by MHBSt
167 and autophagy may work together to be responsible for MHBSt
167-mediated NF-κB activation and subsequent oncogenic phenotype.
This study revealed a novel mechanism of HBV-related HCC. C-terminal truncation of MHBS that occurs during persistent HBV infection can induce an immune response and autophagy and contribute to the development and progression of HCC. Since the present study used an immortalized cell line, further study in non-immortalized cells and in vivo experiments might be needed to verify the carcinogenic mechanism of MHBSt167. Furthermore, as the mutation in the S region that leads to C-terminally truncated MHBS may generate C-terminally truncated LHBS and SHBs as well, the latter two truncated surface proteins may act synergistically with MHBSt in the development of HCC.
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.