Additionally, FXR

Additionally, FXR selleck chemicals indirectly represses the

expression of bile acid import [Na+-taurocholate cotransporting polypeptide (NTCP)7] and synthesis genes [cytochrome P450 7A1 (CYP7A1) and cytochrome P450 8B1 (CYP8B1)8] through the induction of a transcriptional repressor, small heterodimer partner (SHP), in the liver8 and a signaling hormone, fibroblast growth factor 19 (FGF19)/Fgf15, in the intestine.9 FXR therefore plays a central role in preventing the toxic accumulation of bile acids in the liver. Intrahepatic cholestasis of pregnancy (ICP) is characterized by raised serum bile acid levels and abnormal liver function tests. The disease is associated with fetal distress, spontaneous preterm delivery, and unexplained

intrauterine death.10 We have identified genetic variants of FXR, BSEP, and MDR3 that contribute to the etiology of ICP.11-13 However, it is currently not known Seliciclib how pregnancy unmasks cholestatic disease in these genetically predisposed but otherwise normal individuals. Importantly, gestation itself may be a state of impaired bile acid homeostasis because up to 40% of women develop asymptomatic hypercholemia of pregnancy,14 and an increase in the total bile acid pool has also been reported.15 As such, the mechanisms that affect bile acid homeostasis during normal pregnancy may also be relevant to the etiology of ICP. For a number of reasons, estrogens are thought to contribute to the etiology of ICP.16

First, the disease usually develops in the third trimester of pregnancy when concentrations of estrogens are highest. Second, twin pregnancies have both a higher incidence of ICP and a more pronounced rise in estradiol concentrations.17 Third, ICP patients can present with cholestasis outside of pregnancy when they are taking oral contraceptives containing 17α-ethinylestradiol.18 High doses of estradiol and its metabolites also cause cholestasis in rodents,19 and mice lacking ER are resistant to these effects.20 Taken together, these findings imply 上海皓元 that estrogens could dysregulate bile acid homeostasis in normal pregnant women and trigger cholestatic disease in genetically predisposed individuals. However, liver biopsy is not clinically indicated in the majority of ICP cases, so data on the response of the human liver to pregnancy and ICP are limited. In this report, we investigate whether bile homeostasis is dysregulated in pregnant mice and whether this is due to impairment of Fxr function. We show that hepatic bile acids are raised in pregnant mice and that liver gene expression is procholestatic and resembles a state of Fxr inactivation. We provide in vivo and in vitro evidence showing that estrogen or its metabolites may be the underlying cause of Fxr dysfunction.

Hepatocellular carcinoma (HCC) is the third most common cause of

Hepatocellular carcinoma (HCC) is the third most common cause of cancer mortality worldwide.1 Although the incidence of this cancer is rising in many countries of the developed world, most deaths occur in Asia and the developing world. Traditionally, external beam radiotherapy has had PD0325901 cell line a very limited role in the treatment

of HCC and is rarely considered in current treatment recommendations of the major Asia–Pacific regions, American and European societies.2,3 There are many reasons for the current lack of interest in radiotherapy. The discouraging early experience with radiotherapy for HCC was a key factor leading to the current widespread belief that HCC is not a ‘radiosensitive’ tumor and that radiotherapy is too ‘toxic’ for the liver. During this era, large HCC were treated with large volume or whole liver radiotherapy, which was associated with high rates of radiation-induced liver disease and poor tumor response rates. As will

be discussed, an understanding of the relationship between the volume of normal tissue (liver) irradiated and tolerable dose is necessary. We are usually mainly concerned about the late radiation effects. Recent developments have concentrated on means of identifying and treating small volumes, because tolerance of liver to radiation is very volume dependant. These developments include the use of radioactive 90Y microspheres locally introduced, stereotactic Tipifarnib manufacturer radiotherapy, the use of intensity modulated X-ray beams and the more exotic and expensive heavy MCE公司 ion therapy. Other means of delivering a local effect include surgery, chemotherapy and percutaneous techniques for tumor ablation. In our view, the roles of radiotherapy, especially

external beam fractionated treatment using standard multifield treatment techniques and modern 3-D computer planning, have been undervalued. It is essential that the radiobiological base for treatment be understood. To help address this problem, the current radiobiology data for HCC and normal liver have been reviewed. These data have been used to describe radiosensitivity of HCC and normal liver and the fundamental concepts of liver tolerance and growth rates of HCC. Tumor control probability when conventional fractionated external beam radiotherapy was used was also examined. The medical published work was reviewed using a computer-based Medline search supplemented by relevant references from primary articles (http://medline.cos.com). These searches were particularly directed to volume doubling times (Tvol) and growth rate of HCC, radiosensitivity of HCC and normal liver and the radiobiology of normal tissue responses. Graphs and associated calculations were generated using Mathcad 2001 software (MathSoft, Cambridge, MA, USA).

Notably, tetracycline was ineffective for CYP3A4 expression Prev

Notably, tetracycline was ineffective for CYP3A4 expression. Previous studies have shown that the formation of the main amiodarone Selleck ZD1839 metabolite, the dealkylated metabolite desethylamiodarone, is catalyzed by CYP3A441 and that amiodarone, but not its metabolite, is a weak inhibitor of CYP3A4-mediated activity.42 In addition to steatosis, amiodarone, like other cationic amphiphilic drugs, induced phospholipidosis, identified as intracellular lamellar inclusion bodies formed by excessive accumulation of phospholipids.

These lamellar bodies were observed in both hepatocyte-like and biliary-like HepaRG cells in agreement with the fact that phospholipidosis can be visualized in various hepatic43 and nonhepatic cell types.44 Up-regulation of the fatty acid biosynthesis-related

gene SCD suggested an enhanced synthesis of phospholipids in HepaRG cells treated with amiodarone for 24 hours. Furthermore, an induction of cholesterol synthesis, supported by overexpression of LSS, was observed, representing an indirect mechanism of phospholipidosis.36 Another gene LPIN1 was specifically overexpressed in HepaRG cells after both acute and repeat amiodarone exposure. LPIN1 encodes the phosphatidate phosphatase-1 enzyme, which converts phosphatidate to diacylglycerol. The resulting diacylglycerol serves as substrate for the synthesis of triacylglycerol as well as phosphatidylethanolamine BGJ398 and phosphatidylcholine.45 Importantly, a strong increase of phosphatidylethanolamine and phosphatidylcholine was observed in HepaRG cells treated with amiodarone for 14 days. In addition, genes involved in phospholipid degradation (GDPD3 and ASML3A) were also up-regulated after 14 days. GDPD3 and LSS were similarly found overexpressed in amiodarone-treated HepG2 cells.36, medchemexpress 46 Some of these genes (ASML3A, GDPD3,

LPL) were modulated specifically after repeat exposure with amiodarone; they likely corresponded to a defense mechanism to reduce phospholipid accumulation and therefore could represent potential biomarkers of drug-induced phospholipidosis. In conclusion, our study provides the first in vitro demonstration of drug-induced vesicular steatosis after repeat treatments. This vesicular steatosis was characterized by an excessive accumulation of TG together with the appearance of Oil Red O–stained lipid vesicles and overexpression of several genes involved in lipogenesis and droplet formation. These data provide new insight into the mechanisms of drug-induced TG accumulation in human hepatocytes and suggest that the HepaRG cell model represents a unique tool for estimating the ability of new drugs to induce steatosis and/or phospholipidosis, as well as other liver injuries, during their early development stage. This cell model should also be appropriate for investigations on steatosis reversibility as well as late steatosis stages leading to steatohepatitis.

The separation of Cronbergia from Cylindrospermum is not supporte

The separation of Cronbergia from Cylindrospermum is not supported by our expanded molecular data set. Since we have included sequences of all five of the foundational species in Bornet and Flahault

(1886) (C. maius, C. stagnale, C. licheniforme, C. muscicola, and C. catenatum) we feel confident that the clade we designate as Cylindrospermum sensu stricto (Fig. 1a, clade X) must be considered to represent the genus. This clade contains Cronbergia siamensis, and given its exceptionally high sequence similarity to C. moravicum GSK1120212 ic50 and C. badium, it is difficult to justify the retention of the genus based on morphological evidence alone. The genus Cronbergia is based on the hypothesis that intercalary heterocyte formation

and apoheterocytic akinete formation denotes significant synapomorphies. We question the interpretation applied to the special intercalary cells considered to be proheterocytes in Cronbergia (Fig. 7, l–n), as we have not observed these developing into heterocytes. The purported intercalary apoheterocytic akinetes are not full-sized akinetes (Fig. 7, o–q), and we are unconvinced that these truly represent developing akinetes. In most studies of heterocyte formation in Cylindrospermum, the heterocytes form terminally after trichome fragmentation (Reddy and Talpasayi 1974, Wolk and Quine 1975, Anand and Rengasamy 1982, Van de Water and Simon 上海皓元医药股份有限公司 1984). There are isolated reports, however, of intercalary heterocyte formation. Baturina (1984) observed intercalary Peptide 17 cost heterocytes in the thermal species C. gregarium (Zakrzhevski) Elenkin. Singh et al. (1980) observed pairs of heterocytes developing in intercalary position in C. planctonicum Singh, Tiwary et Pandey, while Dikshit and Dikshit (1979) report intercalary pairs of heterocytes in C. fertilissimum Dikshit et Dikshit. The latter two taxa possess aerotopes,

and consequently may be closer to Anabaenopsis than Cylindrospermum. These studies suggest that intercalary heterocyte formation is possible in Cylindrospermum sensu lato, weakening the case for recognition of Cronbergia. We looked for intercalary heterocyte development in our strains, but saw no evidence of formation of such heterocytes in Cylindrospermum. Akinete formation in Cylindrospermum has long been considered to be only paraheterocytic and subterminal (Miller and Lang 1968, Hirosawa and Wolk 1979a). However, isolated reports of exceptions occur. C. anabaenoides (Bongale and Singh 1987) was diagnosed as the only Cylindrospermum species with intercalary akinetes. Komárek et al. (2010) reported the formation of swollen cells in intercalary position as possible akinetes in C. stagnale PCC 7417, and considered it evidence that this strain was actually Cronbergia. However, since C.

The clinical and endoscopic efficacy of infliximab and quality of

The clinical and endoscopic efficacy of infliximab and quality of life of patients were evaluated by follow-up of 30 weeks. If a patient is failure to adhere to medication, the end point for the observation is 4 weeks after treatment. Crohn’s disease activity index (CDAI), simple endoscopy score of Crohn’s disease (SESCD) were assessed

before and after treatment. Several predictors, including CRP, SR, ANCA/ASCA, mucosal TNFα and TNFα mRNA were tested. Results: 7 cases of 12 patients are non-strictured and non-penetrating, the other four cases is penetrating. Fistula associated with 5 cases of 10 active patients. There are 2 patients with Crohn’s disease in remission (one with severe lower gastrointestinal bleeding caused by CD, the PLX3397 cell line other with peripheral arthritis associated with enteropathy). After 2 weeks of treatment, among those 10 patients with Selleckchem Dabrafenib active CD, 6 cases presented effective response (60%); the fistula in one of the 5 patients with fistula have become healed; and the patient with peripheral arthritis associated with enteropathy has improved. At the end of observation, clinical remission was found in 5 patients (the

rate of remission is 50%) and 2 cases had clinical response; the two patients with remission remained in remission, one patient with severe lower gastrointestinal bleeding caused by CD were in control of bleeding and absence of further recurrence by 30 weeks follow-up, the symptoms associated with peripheral arthritis have disappeared. 上海皓元医药股份有限公司 At the end of follow-up, endoscopy was performed in 9 patients to evaluate the healing of mucosal ulceration, with ulcers in 3 cases basically healing, and ulcers in other 6 cases becoming smaller in size and less in number. Adverse events were seen in 4 out of 12 patients with infiiximab treatment, among whom two case with leukopenia gets recovery after stopping infliximab, the other two suffered severe Varicella and Herpes Zoster, respectively, and both of them are cured after anti-virus therapy. We use SF-12 to evaluate quality of life, which has improved after

treatment. Age, disease duration, CDAI, SESCD, CRP, SR, ANCA/ASCA and mucasal TNFα did not predict clinical remission. There was an inverse association between pre-treatment TNFα mRNA expression levels and clinical response of IFX treatment. Conclusion: Infliximab is effective in the induction and maintenance of remission and fistula healing, with low incidence of adverse events. The clinical outcome of IFX teatment was inversely associated with the pre-treatment gene expression levels of TNFα in colorectol mucosa. However, its long-term efficacy, safety and real independent predictor need further studies with large patients to confirm. Key Word(s): 1. infliximab; 2. Crohn’s disease; 3. efficacy; 4.

Aims: To investigate whether the clinical and biochemical profile

Aims: To investigate whether the clinical and biochemical profiles and the grade of severity of the acute pancreatitis are dependent on their origin. Methods: METHOD SThis was a retrospective observational and comperative study of a total of 70 patients with AP, 48 males (68.8%) and 22 female (31.4%), with a mean age of 54.5 ± 16.4 y/old, who were admitted to our clinic

between Jannuary AZD5363 1, of 2009 to December 31, 2011. Multiple factor scoring system (Ranson’s criteria and APACHE II classification system) and individual risk factors determined with blood biochemical data, such as white cell, amylasemia, blood urea nitrogen (BUN), creatininemia, aspartate aminotransferase (AST) and www.selleckchem.com/products/ABT-888.html fasting blood sugar obtained at the time of admission were used for estimating the clinical-biochemical profiles and severity of disease. Means, standart deviations and percentage were reported for various biochemical markers. The comparison between two groups of the patients (gallstone and alcoholic AP) were done using student’s T-test and Chi-square test (Cl 95%) with

statistical significance if p < 0.05. Results: RESULTS: AP was associated with gallstone disease in 24/70 (34.3%), due to alcoholic abuse in 34/70 (48.6) and with other risk factors in 12/70 (17.1%). There were no differences in BUN and creatinine between the patients with 上海皓元医药股份有限公司 gallstone and alcoholic AP (40.8 ± 18.6 vs 35.2 ± 5.85 and 1.08 ± 0.52 vs 0.95 ± 0.1). Although without statistically significant difference the M ± SD value of Ranson criteria and AST levels were higher among patients with gallstone AP than those with alcoholic AP (2.47 vs 2.3 and 108.5 ± 73 vs 79.68 ± 46.3), whereat that the M ± SD value of

fasting blood sugar was higher in the patients with alcoholic AP (169.5 ± 121.1 vs 134 ± 45.6). The APACHE II grade classification system, white cells and amylasemia were increased significantly more among patients with gallstone AP (p < 0.0026, p < 0.05 and p < 0.003 respectively). Conclusion: CONCLUSION: Gallstone AP were positively associated with severity of disease. Use of individual risk markers of pancreatic injury and inflammatory response, in combination with multiple factor scoring system can be useful in distinguished gallstone from alcoholic AP. White cells number and serum amylasemia are the most discriminant test between gallstone and alcoholic AP. Key Word(s): 1. acute pancreatitis; 2. severity of AP; 3. risk markers of PA; 4. Gallstone AP; Presenting Author: BASHKIM RESULI Additional Authors: ANILA KRISTO, JOVAN BASHO, ADRIANA BABAMETO, JONILA CELA, ELA PETRELA, KLERIDA SHEHU, IRGEN TAFAJ Corresponding Author: ANILA KRISTO Objective: INTRODUCTION: The clinical spectrum of acute pancreatitis (AP) depends greatly on whether or not pancreatic necrosis is present and to what extent.

Fifty consecutive patients with ALI/ALF were recruited prospectiv

Fifty consecutive patients with ALI/ALF were recruited prospectively from admissions at VCU Medical Center. ALI was defined as liver injury in a patient with no known previous liver disease, an admission INR of ≥1.5, and a duration of illness of ≤26 weeks. ALF was defined as ALI in the presence of HE. Some patients in the current study population also participated in two previous studies exploring hemostasis in ALI/ALF.6, 8 For the present study, 13 healthy volunteer controls were also recruited for the collection of 5 mL of whole blood for plasma. Controls were of similar age (39 years) and gender distribution

(54% female) as the study population (P = 0.6 and 0.2, respectively). SIRS components were determined at time of admission to the study by standard criteria, and the presence of the SIRS was defined as two to four positive www.selleckchem.com/products/Neratinib(HKI-272).html SIRS components.24 Complications

of ALI/ALF, including bleeding, thrombosis, and infection, were defined previously6 and occurred late after admission (on or after day 3). Bleeding sites included gastric mucosal erosions (N = 6) and cutaneous (N = 3), none of which lead to the need for blood transfusion. Thrombotic events selleck compound included occlusion of renal replacement therapy (RRT) catheters (N = 6), portal venous thrombosis (N = 2), and limb vessel thrombosis (N = 1). Sites of infection included lung (N = 5), urine (N = 4), blood (N = 3), and ascites (N = 1) and were identified relatively late after admission (>3 days after admission). As per ALFSG protocol, outcomes (death, LT, or transplant-free survival [TFS]) were determined at day 21 after admission. Standard laboratories were collected

on admission to the hospital (day 1) and daily for 7 days. For the analyses herein, laboratories drawn on days 1 and 3 after admission were analyzed. Whole blood from days 1 and 3 was also collected for PPP in 5-mL citrated Vacutainer tubes. Because enrolled patients were purposely chosen to represent a wide range of liver injury severity, blood was drawn by in-dwelling venous catheters, radial artery catheters, and butterfly needle catheters, depending upon whether patients were in a floor bed medchemexpress or intensive care unit, and the availability of vascular access. Blood was centrifuged at 1,500×g for 20 minutes at room temperature, aliquotted, and PPP was frozen at −80°C within 2 hours of drawing. MPs were analyzed by Invitrox Sizing, Antigen Detection, and Enumeration (ISADE; Invitrox, Inc., Research Triangle Park, NC).23 Batches of 10-20 PPP samples, randomly selected, were injected into the detection chamber using a fixed volume of 200 μL/sample. Testing time for sizing and enumeration was 6 minutes/sample. To eliminate any contribution from buffer/diluent, background counts were subtracted from each sample result.

4 Short-term/acute ethanol exposure increases IL-10 expression by

4 Short-term/acute ethanol exposure increases IL-10 expression by monocytes in human subjects, as well as in mice in response to LPS. When human subjects consume a single dose of alcohol, the production of IL-10 by isolated monocytes in response to LPS is increased compared with controls.25 This increase can be prevented by inhibiting HO-1 by pretreatment with zinc protoporphyrin.26 Taken together with the current data, it appears that although chronic

ethanol exposure decreases circulating concentrations of IL-10,4 both short-term/acute and chronic ethanol exposure contribute to an enhanced IL-10 expression PLX4032 in vivo in monocytes/macrophages in response to immunoregulatory signals, such as LPS or gAcrp. Dabrafenib datasheet IL-10 binds to a heterodimeric IL-10R, which undergoes transphosphorylation and then activates the Janus kinase/signal transducer and activator of transcription protein 3 (STAT3) pathway.27 Activation of STAT3 is essential for IL-10–dependent signaling.2 Chronic ethanol feeding increased IL-10–stimulated phosphorylation of JAK1 and STAT3 in

Kupffer cells. Furthermore, inhibition of STAT3 signaling through chemical inhibitors or through siRNA knockdown ameliorated IL-10–dependent expression of HO-1 (Fig. 6). Reports in the literature suggest that the impact of chronic ethanol on the regulation of STAT3 is complex and is likely to have ligand-specific and cell-type–specific effects. Exposure of primary cultures of hepatocytes to ethanol suppresses IL-6–stimulated STAT3 activation.28 Horiguchi and colleagues have identified cell specific roles for STAT3 in hepatocytes

compared with monocytes/macrophages in the liver.29 Expression of STAT3 in hepatocytes had a negative impact on liver injury and promoted inflammation, whereas expression of STAT3 in monocytes/macrophages suppressed inflammation during ethanol exposure.29 The anti-inflammatory role of STAT3 in monocytes/macrophages during chronic ethanol exposure is consistent with our identification of a critical contribution of STAT3 in Kupffer cells in mediating the anti-inflammatory effects MCE公司 of gAcrp. Accumulating evidence suggests that HO-1 plays an important anti-inflammatory role in chronic inflammatory diseases and protects cells from oxidative insult.15 Heme oxygenase catalyzes the initial and rate-limiting step in oxidative degradation of heme, yielding equimolar amounts of biliverdin IXα, carbon monoxide, and free iron.30 There are three isoforms of HO: HO-2 and HO-3 are constitutive forms, whereas HO-1 (also known as heat shock protein 32) is an inducible isozyme, with high expression levels in spleen and Kupffer cells.31 HO-1 is a stress-responsive protein whose expression is up-regulated by a broad spectrum of inducers, including heme, heavy metals, nephrotoxins, cytokines, endotoxins, and oxidative stress.

The size and incidence of subcutaneous tumors were recorded every

The size and incidence of subcutaneous tumors were recorded every week. These procedures were approved by The Animal Care and

Use Committee of Fudan University. The cutoff value used in prognosis was estimated using X-tile 3.6.1 software (Yale University, New Haven, CT).21 The results indicated that in blood, a threshold CTC7.5 value of 2 showed the most significant power selleckchem to predict patient outcome (Supporting Fig. 1); therefore, it was used in all further analyses. Receiver operating characteristic (ROC) analysis confirmed that this level was the optimal cutoff. Statistical analyses were performed with SPSS version 19.0 for Windows (IBM). Data are presented as the mean ± SEM. A chi-squared test, Fisher’s exact test, and Student t test were used for comparison between groups where appropriate.

The relationship between the TTR and CTC counts was analyzed using Kaplan-Meier survival curves and a selleck kinase inhibitor log-rank test. Univariate and multivariate analyses were based on the Cox proportional hazard regression model. P < 0.05 was considered statistically significant. ROC curve analysis was used to determine the predictive value of the parameters, and the differences in the area under the curve (AUC) were detected using Stata version 10 (StataCorp, College Station, TX). The mRNA levels of four putative hepatic CSC biomarkers (EpCAM, CD133, CD90, and ABCG2) were determined via qRT-PCR analysis in CD45-depleted peripheral blood mononuclear cells of 30 HCC patients and 20 healthy volunteers. The expression of EpCAM was significantly higher in cells of HCC patients versus healthy controls (P < 0.05), whereas there was no significant difference in the expression of CD133, CD90, or ABCG2 between the groups (P > 0.05) (Fig. 1A). These data suggested that EpCAM might be a reliable biomarker to identify circulating CSCs in HCC. Because the mRNA level of EpCAM was highly expressed MCE公司 in CD45-depleted peripheral blood mononuclear cells of HCC patients, we investigated the prevalence of EpCAM+ CTCs in HCC patients

using the CellSearch system. CTCs detected with the CellSearch system were defined as nucleated intact cells that were positive for cytokeratins and negative for CD45 (Fig. 1B).8 Apoptotic CTCs, defined as CTCs with fragmented, condensed 4′,6-diamidino-2-phenylindole (DAPI)-stained nuclear,22 were also enumerated and examples were shown in Fig. 1B. The apoptotic cells were excluded from the CTC counts and recorded separately. Preoperatively, EpCAM+ CTCs were detected in 82 of 123 HCC patients at CTC7.5 levels within a range of 1-34, and 51 patients had counts of ≥2. No CTCs were detected in 41 HCC patients or in any of the blood samples derived from healthy volunteers or patients with benign liver disease.

Rats were placed in metabolic cages with free access

to f

Rats were placed in metabolic cages with free access

to food and water to collect urine over a 24-h period. Oral tolvaptan (1 and 3 mg/kg) promoted a remarkable diuretic effect, decreasing bodyweight and abdominal circumference in a dose-dependent manner. Plasma sodium concentration was increased by tolvaptan due to the large amount of free-water excretion following tolvaptan administration. Tolvaptan had therapeutic efficacy in the reduction of ascites in rats with chronic liver injury. These results are consistent with the clinical data showing tolvaptan has therapeutic implications in the reduction of ascites in patients with decompensated cirrhosis. “
“Sirtuin 6 (SIRT6) is a member of the sirtuin family of NAD+–dependent deacetylases. Genetic Rapamycin concentration deletion of Sirt6 in mice results in a severe degenerative phenotype with impaired liver function and premature death. The role of SIRT6 in development and progression of hepatocellular carcinoma is currently unknown. We first investigated SIRT6 expression in 153 primary human liver cancers and in normal and cirrhotic livers using microarray analysis. SIRT6 selleck inhibitor was significantly down-regulated in both cirrhotic livers and cancer. A Sirt6 knockout (KO) gene expression signature was generated from primary hepatoctyes isolated from 3-week-old Sirt6-deficient animals. Sirt6-deficient hepatocytes

showed up-regulation of established hepatocellular carcinoma (HCC) biomarkers alpha-fetoprotein (Afp), insulin-like growth factor 2 (Igf2), H19, and glypican-3. Furthermore, decreased SIRT6 expression was observed in hepatoma cell lines that are known to be apoptosis-insensitive. Re-expression of SIRT6 in HepG2 cells increased apoptosis sensitivity to CD95-stimulation or chemotherapy treatment. Loss of Sirt6 was characterized by oncogenic changes,

such as global hypomethylation, medchemexpress as well as metabolic changes, such as hypoglycemia and increased fat deposition. The hepatocyte-specific Sirt6-KO signature had a prognostic impact and was enriched in patients with poorly differentiated tumors with high AFP levels as well as recurrent disease. Finally, we demonstrated that the Sirt6-KO signature possessed a predictive value for tumors other than HCC (e.g., breast and lung cancer). Conclusion: Loss of SIRT6 induces epigenetic changes that may be relevant to chronic liver disease and HCC development. Down-regulation of SIRT6 and genes dysregulated by loss of SIRT6 possess oncogenic effects in hepatocarcinogenesis. Our data demonstrate that deficiency in one epigenetic regulator predisposes a tumorigenic phenotype that ultimately has relevance for outcome of HCC and other cancer patients. (Hepatology 2013;53:1054–1064) Hepatocellular carcinoma (HCC) is the most deadly consequence of the majority of chronic liver diseases.