Institute of Digestive Disease and Department of Medicine and Therapeutics, Li Ka Shing Institute of Health Sciences, the Chinese University of Hong Kong, Hong Kong.
J Gastroenterol Hepatol. 2012 Nov;27(11):1665-9. doi: 10.1111/j.1440-1746.2012.07213.x.
Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide. Major risk factors of HCC include infection with hepatitis B or C viruses, alcohol and non-alcoholic fatty liver disease. HCC is difficult to diagnose at early stage, and has a very poor survival rate when diagnosed at a late stage. The majority of HCC-related deaths result from local invasion (to cause liver failure) or distant metastases. There is an urgent need to identify effective molecular targets for the treatment of the disease. As the target of an established class of therapeutic agent thiazolidinediones (TZDs), peroxisome-proliferator-activated receptor γ (PPARγ) has been widely studied for its role in the development of HCC. A substantial body of evidence based on in vitro and in vivo models indicates that the activation of PPARγ is able to inhibit HCC cell proliferation and tumor growth through inducing cell cycle arrest and apoptosis via the regulation of a panel of downstream effector molecules. PPARγ activation also induces an inhibitory effect on HCC metastasis. Meanwhile, there is new evidence suggesting that PPARγ inhibition could also be anti-tumorigenic. In the present review, we summarize the available information on the role of PPARγ in HCC development and spread, and discuss whether PPARγ activation by TZDs could play a role in the treatment of HCC, summarizing both in vitro and in vivo. Considering the available data, PPARγ seems to exert beneficial effects against HCC and may therefore represent as a therapeutic target.
肝细胞癌(HCC)是全球第五大常见癌症。HCC 的主要危险因素包括乙型肝炎或丙型肝炎病毒感染、酒精和非酒精性脂肪性肝病。HCC 在早期阶段难以诊断,在晚期诊断时存活率非常低。大多数 HCC 相关死亡是由于局部侵袭(导致肝功能衰竭)或远处转移。因此,迫切需要确定治疗该疾病的有效分子靶标。过氧化物酶体增殖物激活受体 γ(PPARγ)作为一类已确立的治疗剂噻唑烷二酮(TZDs)的靶标,已广泛研究其在 HCC 发展中的作用。大量基于体外和体内模型的证据表明,通过调节一组下游效应分子,PPARγ 的激活能够通过诱导细胞周期停滞和细胞凋亡来抑制 HCC 细胞增殖和肿瘤生长。PPARγ 激活还对 HCC 转移具有抑制作用。同时,有新的证据表明,PPARγ 抑制也可能具有抗肿瘤作用。在本综述中,我们总结了 PPARγ 在 HCC 发展和扩散中的作用的现有信息,并讨论了 TZDs 是否可以通过激活 PPARγ 来发挥作用治疗 HCC,总结了体外和体内的情况。考虑到现有数据,PPARγ 似乎对 HCC 具有有益的作用,因此可能代表一种治疗靶标。