State Key Laboratory of Holistic Integrative Management of Gastrointestinal Cancers and National Clinical Research Center for Digestive Diseases, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi'an 710032, Shaanxi Province, China.
Department of Gastroenterology, Institute of Liver and Gastrointestinal Diseases, Hubei Key Laboratory of Hepato-Pancreato-Biliary Diseases, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China.
Theranostics. 2023 Jul 14;13(12):4042-4058. doi: 10.7150/thno.84388. eCollection 2023.
Metastasis is a major cause of HCC-related deaths with no effective pharmacotherapies. Chronic inflammation promotes HCC dissemination, however, its underlying mechanisms are not fully understood. Here, we investigated the role of Krüppel-like factor 7 (KLF7) in inflammation-provoked HCC metastasis and proposed therapeutic strategies for KLF7-positive patients. The expression of KLF7 in human HCC specimens were examined by immunohistochemistry and quantitative real-time PCR. The luciferase reporter assays and chromatin immunoprecipitation assays were conducted to explore the transcriptional regulation related to KLF7. Orthotopic xenograft models and DEN/CCl-induced HCC models were established to evaluate HCC progression and metastasis. KLF7 overexpression promotes HCC metastasis through transactivating toll-like receptor 4 (TLR4) and protein tyrosine kinase 2 (PTK2) expression. High mobility group box 1 (HMGB1) upregulates KLF7 expression through the TLR4/advanced glycosylation end-product specific receptor (RAGE)-PI3K-AKT-NF-κB pathway, forming an HMGB1-KLF7-TLR4 positive feedback loop. The HMGB1-KLF7-TLR4/PTK2 axis is gradually activated during the progression of inflammation-HCC transition. Genetic depletion of KLF7 impedes HMGB1-mediated HCC progression and metastasis. The combined application of TLR4 inhibitor TAK-242 and PTK2 inhibitor defactinib alleviates HCC progression and metastasis induced by the HMGB1-KLF7 axis. In human HCCs, KLF7 expression is positively correlated with cytoplasmic HMGB1, p-p65, TLR4, and PTK2 levels, and patients positively co-expressing HMGB1/KLF7, p-p65/KLF7, KLF7/TLR4 or KLF7/PTK2 exhibit the worst prognosis. HMGB1-induced KLF7 overexpression facilitates HCC progression and metastasis by upregulating TLR4 and PTK2. Genetic ablation of KLF7 via AAV gene therapy and combined blockade of TLR4 and PTK2 represents promising therapy strategies for KLF7-positive HCC patients.
转移是 HCC 相关死亡的主要原因,目前尚无有效的药物治疗方法。慢性炎症促进 HCC 的扩散,但其潜在机制尚不完全清楚。在这里,我们研究了 Krüppel 样因子 7(KLF7)在炎症诱导的 HCC 转移中的作用,并提出了针对 KLF7 阳性患者的治疗策略。通过免疫组织化学和定量实时 PCR 检测人 HCC 标本中 KLF7 的表达。进行荧光素酶报告基因检测和染色质免疫沉淀检测,以探讨与 KLF7 相关的转录调控。建立原位异种移植模型和 DEN/CCl 诱导的 HCC 模型,以评估 HCC 的进展和转移。KLF7 的过表达通过反式激活 toll 样受体 4(TLR4)和蛋白酪氨酸激酶 2(PTK2)的表达促进 HCC 的转移。高迁移率族蛋白 B1(HMGB1)通过 TLR4/晚期糖基化终产物特异性受体(RAGE)-PI3K-AKT-NF-κB 途径上调 KLF7 的表达,形成 HMGB1-KLF7-TLR4 正反馈环。HMGB1-KLF7-TLR4/PTK2 轴在炎症-HCC 转化过程中逐渐激活。KLF7 的遗传缺失可阻止 HMGB1 介导的 HCC 进展和转移。TLR4 抑制剂 TAK-242 和 PTK2 抑制剂 defactinib 的联合应用可减轻 HMGB1-KLF7 轴诱导的 HCC 进展和转移。在人 HCC 中,KLF7 的表达与细胞质 HMGB1、p-p65、TLR4 和 PTK2 水平呈正相关,并且共同表达 HMGB1/KLF7、p-p65/KLF7、KLF7/TLR4 或 KLF7/PTK2 的患者预后最差。HMGB1 诱导的 KLF7 过表达通过上调 TLR4 和 PTK2 促进 HCC 的进展和转移。通过 AAV 基因治疗进行 KLF7 的遗传消融和 TLR4 和 PTK2 的联合阻断代表了针对 KLF7 阳性 HCC 患者的有前途的治疗策略。