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J Biol Chem, Vol. 273, Issue 50, 33327-33332, December 11, 1998


Hepatitis B x Protein Inhibits p53-dependent DNA Repair in Primary Mouse Hepatocytes*

Sandrine ProstDagger , James M. Ford§, Clare Taylor, Jennifer Doig, and David J. Harrison

From the Department of Pathology, University Medical School, Teviot Place, Edinburgh EH8 9AG, Scotland, and the § Department of Medicine and Genetics, Stanford University School of Medicine, Stanford, California 94305-5115

    ABSTRACT
Top
Abstract
Introduction
Procedures
Results
Discussion
References

The mechanisms by which the hepatitis B x protein (HBx) contributes to hepatocarcinogenesis remain unclear. However, interaction with the tumor suppressor gene p53 and inhibition of p53-dependent cellular functions, including nucleotide excision repair, could be central to this process. We studied the levels of global repair (removal of cyclobutane pyrimidine dimers (CPDs) and 6-4 photoproducts) and transcription-coupled repair (removal of CPDs in both strands of the dihydrofolate reductase gene) in primary wild-type and p53-null mouse hepatocytes. We show that global repair of CPDs appears to be more efficient in mouse hepatocytes than in other commonly studied rodent cells and approaches the levels of human cells and that p53 is required for global genomic DNA repair of CPDs but not for transcription-coupled repair. We then investigated the effect of HBx expression on hepatocyte nucleotide excision repair. We demonstrate that HBx expression affects DNA repair in a p53-dependent manner. Transient HBx expression reduces global DNA repair in wild-type cells to the level of p53-null hepatocytes and has no effect on the repair of a transfected damaged plasmid. Therefore, in viral hepatitis, the hepatitis B virus could inhibit the p53-dependent component of global repair leading, over time, to accumulation of genetic defects and fostering carcinogenesis.

    INTRODUCTION
Top
Abstract
Introduction
Procedures
Results
Discussion
References

There is compelling epidemiological evidence that chronic hepatitis associated with hepatitis B virus (HBV)1 infection is a major risk factor for the development of hepatocellular carcinoma (HCC). Among the four viral proteins produced, the small protein hepatitis B x (HBx) is thought to be important in causing HCC, although the mechanism of its involvement has not been defined clearly. Some strains of mice carrying HBx as a transgene show a direct correlation between the level of HBx expression and the likelihood to develop HCC (1, 2). In others, HBx expression increases susceptibility to the development of HCC after exposure to the liver carcinogen diethylnitrosamine (3, 4). A number of mechanisms have been proposed to explain the role of HBx in hepatocarcinogenesis. HBx stimulates the transcription of many genes (for review, see Ref. 5), including transcription factors and oncogenes, and interacts with many cellular proteins (for review, see Ref. 6). One important target of HBx believed to be related to promotion of carcinogenesis is the p53 tumor suppressor protein. Several lines of evidence suggest that functional inactivation of p53 without mutation can occur in preneoplastic liver and that, in these circumstances, p53 mutation and allele loss are later events (7-11), occurring after carcinogenesis and mediating tumor progression. Indeed, accumulation of wild-type p53 has been observed in hepatocytes of patients with cirrhosis and liver cell dysplasia, both associated with high risk for HCC development, particularly in patients infected with HBV (10, 12-14). Observations both in vitro and in vivo (15, 16) and in HBx-transgenic mice (17) have suggested that HBx interacts and inactivates p53, possibly by cytoplasmic sequestration (10, 18). In transgenic mice (17), this functional inactivation of p53 is associated topographically with subsequent development of HCC. Moreover, HBx and p53 can be coprecipitated from liver samples of patients with HCC (19), supporting this idea.

It is important to identify the functions of p53 which HBx could target and so promote carcinogenesis. p53 is critical for the maintenance of genomic fidelity. Current models hold that cells respond to DNA damage by stabilization of p53 leading either to checkpoint arrest, allowing repair, or to p53-dependent apoptosis, eliminating a potentially mutated cell from the population. Work from our laboratory has established the existence of p53-dependent cell cycle arrest in hepatocytes after DNA damage but also indicates that hepatocytes do not undergo apoptosis readily in response to DNA damage (20). Therefore, effective DNA repair, also shown to be partially p53-dependent in these cells (21), must be critical to prevent development of mutations because the hepatocytes do not self-delete in the presence of a low, but significant, level of DNA damage.

Therefore, a functional blockage of p53 by HBx could be a critical event in cells sustaining DNA damage, leading to inhibition of p53-dependent cell cycle arrest (20) but also alteration of p53-dependent DNA repair (21). Interestingly, HBx binding to p53 was reported recently to inhibit the interaction between p53 and the two DNA repair proteins XPB and XPD, part of the TFIIH complex (22). In addition, a direct effect upon DNA repair by HBx is suggested by the ability of HBx to bind damaged DNA in vitro (23) and to interact directly with at least three DNA repair proteins: XAP-1/UV-DDB (24), XPB, and XPD (25). Therefore, alteration of DNA repair, either directly or indirectly through inhibition of p53, could be a major contribution of HBx in carcinogenesis.

In the present study, we have used wild-type and p53-null primary hepatocytes to investigate the effect of HBx expression on p53-dependent and -independent DNA repair in the liver.

    EXPERIMENTAL PROCEDURES
Top
Abstract
Introduction
Procedures
Results
Discussion
References

Cells-- Primary hepatocytes were isolated from adult wild-type or p53-null male mice (26) 6-10 weeks of age by a two-step EDTA/collagenase retrograde perfusion protocol and cultured as described previously (20).

Transfection and Plasmids-- All transfections were performed using Tfx-50 (Promega Biotech). Briefly, plasmid DNA (3 µg) and Tfx-50 (15.5 µg) in 300 µl of warm culture medium were incubated for 15 min at room temperature before laying the complex over the cells in culture in 12-well plates for 24 h. After 3 h of incubation at 37 °C, the DNA-containing medium was replaced by fresh medium, and experiments were performed 24-72 h later. Using this technique about 80% of hepatocytes were transfected.

The p53 reporter plasmid pRGCDelta FosLacZ contains two copies of the RGC p53-specific binding site placed upstream of a nonfunctional fos promoter and a lacZ gene (27). The HBx expression vector (15) pCMV-x1 encoded for the entire HBx open reading frame under the control of the cytomegalovirus (CMV). Efficient expression from the HBx expression vector was monitored by reverse transcriptase-polymerase chain reaction using two different sets of primers.

The plasmids used for the host cell reactivation assay are the chloramphenicol acetyltransferase (CAT) reporter plasmid pOP13 CAT (Stratagene) and the LacZ-expressing plasmid pbeta CMV (CLONTECH).

p53 Immunocytochemistry-- Primary hepatocyte monolayers on chamber slides (LabTek) were transfected with pCMV-x1 or a control plasmid, cultured for a further 30-36 h, then UV-C irradiated (10 J/m2) and fixed at the indicated times in acetone:methanol (1:1 v/v). Immunocytochemistry for p53 protein was performed by a standard avidin-biotin peroxidase technique using a primary monoclonal anti-p53 antibody pAb 421 (Oncogene Science; 1/1,000 dilution) as described previously (28).

p53 Reporter Plasmid-- Primary hepatocytes cultured for 24 h in fibronectin-coated 12-well plates (0.3 × 105 cells/cm2) were transiently cotransfected with a p53 reporter plasmid, pRGCDelta FosLacZ, and either the HBx expression vector (pCMV-x1) or a control plasmid (pBR322) (ratio of 10:3). 36 h after transfection cells were UV-C irradiated (10 J/m2) or not; cultured for a further 4, 8, 14, or 24 h; and then lysed in 200 µl of reporter lysis buffer (Promega Biotech). beta -Galactosidase activity was determined using an o-nitrophenyl-beta -D-galactopyranoside substrate assay (Promega Biotech) and is expressed relative to the amount of protein (Bio-Rad protein assay) recovered from each well, as described previously (28).

Unscheduled DNA Synthesis-- Primary hepatocytes transfected with pCMV-x1 or a control plasmid were cultured for 48 h, irradiated with the indicated doses of UV-C, and incubated for a further 3 h in medium supplemented with 10 µCi/ml tritiated thymidine. The radioactive medium was removed, and cells were incubated in fresh medium containing 1 mM nonradioactive thymidine for an additional hour. The cultures were then fixed in Boum's fixative, counterstained with Feulgen, then dipped in LM-1 autoradiographic emulsion (Amersham Pharmacia Biotech). Processing and grain counting were performed as described previously (21). For each culture, 10 high power (× 400) fields were assessed, each field containing 20-40 nuclei. The grain density within nuclei was corrected for background (non-nuclear) labeling by subtraction and expressed per surface area of nuclei (= nuclear grain index). The results shown are histograms of the nuclear grain index for one typical experiment. For the calculation of the mean nuclear grain index, only values smaller than 40 were considered in order to exclude cells in DNA synthesis. The experiment was performed twice (two wild-type and two p53-null mice) with similar results.

Reactivation of a UV-C-irradiated Reporter Plasmid-- Primary hepatocytes were transfected with either pCMV-x1 or the control plasmid as described above. 36 h later, a second transfection was performed using the pOP13 CAT reporter plasmid treated with UV-C at various doses and undamaged pbeta CMV in a 1:1 ratio. 24 h after transfection the cells were lysed in reporter lysis buffer.

The CAT activity in transfected cells was measured by liquid scintillation counting assay as described previously (21). The results were corrected for the transfection efficiency, given by the beta -galactosidase activity resulting from the undamaged pCMVbeta expression/µg of protein.

Global Genomic Nucleotide Excision Repair Immunoassay-- The relative number of cyclobutane pyrimidine dimers (CPDs) and 6-4 photoproducts in total genomic DNA was determined using an immunoblot assay as described previously (29). Briefly, hepatocytes in culture for 8 h were UV irradiated (10 J/m2) and collected 2, 6, 12, or 24 h later and lysed, and the DNA was extracted by phenol/chloroform and ethanol precipitation. During this period of time, freshly isolated primary hepatocytes show no replicative DNA synthesis (30, 31), and so it was not necessary to eliminate newly replicated DNA.

DNA was then denatured by boiling for 5 min and placing on ice, and equal amounts of genomic DNA from each sample were fixed to a Hybond N+ nylon membrane (Amersham Corp.) in triplicate using a slot-blot apparatus (0.1 and 1 µg of DNA/slot for detection of CPDs and 6-4 photoproducts, respectively).

Genomic DNA from unirradiated cells was used as a control for nonspecific DNA binding of the monoclonal antibodies. The membrane was incubated for 1 h with mouse monoclonal antibodies specific for either CPDs (TDM-2) or 6-4 photoproducts (64M-2), at a dilution of 1/2,000 in phosphate-buffered saline. Detection of primary antibody was performed using horseradish peroxidase-conjugated secondary antibody and enhanced chemoluminescence (Amersham Corp.). After antibody detection, equal DNA loading to each slot of the membrane was confirmed by scintillation spectrophotometry. Two separate slot blots were performed, in triplicate, using DNA from three wild-type, one heterozygous, and two p53-null mice.

Analysis of Strand-specific DNA Repair-- Repair of CPDs within the transcribed and nontranscribed strand of the dihydrofolate reductase (DHFR) gene was performed as described previously (30, 31) using a Southern-based method. Primary hepatocytes were lysed at various times after UV irradiation (10 J/m2), and DNA was extracted. After digestion with BamHI, DNA samples were treated with T4 endonuclease V or not, electrophoresed, and transferred onto a membrane. After hybridization with a 32P-labeled strand-specific probe to the murine DHFR gene (plasmid supplied by Isabel Mellon) and autoradiography, the ratio of full-length restriction fragments in the T4 endonuclease V-treated and untreated samples was determined by PhosphorImager analysis (Bio-Rad model GS-363) and was used to calculate the average number of CPDs/fragment using the Poisson expression. DNA samples from each mouse (two wild-type, one heterozygous, and one p53-null) were used for two independent Southern blots, each probed for both the transcribed and the nontranscribed strand of the DHFR gene.

    RESULTS
Top
Abstract
Introduction
Procedures
Results
Discussion
References

Nucleotide Excision Repair in Primary Hepatocytes-- The role of p53 in the repair of CPDs and 6-4 photoproducts in overall genomic DNA and in the repair of CPDs in individual strands of the DHFR gene was examined using primary hepatocytes isolated from wild-type, p53 heterozygous, and p53-null mice.

First, the global repair of UV-induced DNA damage was determined using monoclonal antibodies against CPDs and 6-4 photoproducts. Both wild-type and p53 heterozygous primary hepatocytes exhibit efficient global repair of both lesions (Fig. 1). By contrast, p53-null cells show a strong reduction in the repair of CPDs, whereas removal of 6-4 photoproducts remains normal.


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Fig. 1.   Global genomic nucleotide excision repair in wild-type and p53 -/- mouse primary hepatocytes. Removal of CPDs and 6-4 photoproducts was performed on genomic DNA extracted from wild-type, p53 -/+, and p53 -/- hepatocytes 2, 6, 12, or 24 h after UV treatment (10 J/m2). Two separate slot blots were performed, in triplicate, using DNA from three wild-type, one heterozygous, and two p53-null mice.

Second, the repair of CPDs was studied in both the transcribed and the nontranscribed strand of the DHFR gene. The repair of the transcribed strand of DHFR was proficient and similar in both cell types, whereas the repair of the nontranscribed strand, although still measurable, was found to be slower in p53-/- cells compared with wild-type cells (Fig. 2). Taken together with our previous results in mouse primary hepatocytes (21) and in human fibroblasts (29, 31, 32), this suggests that p53 is required for efficient global nucleotide excision repair but not for transcription-coupled repair.


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Fig. 2.   Time course of strand-specific removal of CPDs from the DHFR gene in wild-type and p53 -/- mouse primary hepatocytes. Quantitative Southern hybridization with strand-specific RNA probes to the DHFR gene was performed on BamHI-restricted DNA isolated from wild-type (bullet , open circle ), p53-/+ (black-triangle, triangle ), and p53-/- (black-square, ) primary hepatocytes 6, 12, and 24 h after UV irradiation (10 J/m2). DNA samples from each mouse (two wild-type, one heterozygous, and one p53-null) were used for two independent Southern blots, each probed for both the transcribed (bullet , black-triangle, black-square) and the nontranscribed strand (open circle , triangle , ) of the DHFR gene.

By contrast to other mouse cell types, which inefficiently repair CPDs in bulk DNA (33, 34), we found the global repair of CPDs in primary hepatocytes to be very efficient and to approach the levels observed in human cells. This finding suggests that nuclear excision repair is a critical process in the liver.

Effect of HBx Protein on Primary Hepatocyte Responses to DNA Damage-- Independently of UV treatment, transient expression of pCMV-x1 had no effect on the level of cell death in either wild-type or p53-/- cells. The rate of apoptotic cell death was 1-5%.

In the absence of DNA-damaging treatment, the prevalence of p53 immunopositivity in HBx-transfected cells was similar to that of control cells (5-10% of cells) (Fig. 3A). After UV irradiation, the proportion of p53-immunopositive cells increased in both normal and transfected hepatocytes. Interestingly, the proportion of hepatocytes showing nuclear immunopositivity was significantly smaller in HBx-transfected hepatocytes compared with controls (Fig. 3, A and B). This difference between HBx-transfected cells and controls was transient, lasting no longer than 24 h after irradiation (Fig. 3, A and B). Consistent with this result, we also found that HBx expression reduces significantly the rise in p53 transactivation activity which normally follows UV irradiation, especially during the first 12 h after it (Fig. 3C). The absence of a difference between transfected and control cells at later time points after irradiation reflects the kinetics of expression of the transiently transfected plasmid; expression decreases rapidly after about 60 h (28).


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Fig. 3.   Effect of HBx expression on p53 stabilization (panels A and B) and transactivation function (panel C). Panel A, primary wild-type hepatocytes were transfected as described under "Experimental Procedures." 36 h after transfection, cells were treated with UV (10 J/m2) or not, and p53 immunocytochemistry was performed. Results give the percentage of nuclear immunopositivity in wild-type culture transfected with pCMV-x1 or a control plasmid at various times after UV treatment of one typical experiment. The experiment was performed three times with similar results. Panel B, percentage of cells that are p53-positive among primary hepatocytes transfected with pCMV-x1 relative to hepatocytes transfected with a control plasmid, averaged from three independent experiments ± S.E. Panel C, hepatocytes in culture for 24 h were cotransfected with the p53 reporter plasmid (RGCDelta FosLacZ) and either the HBx expression vector pCMV-x1 or a control plasmid as described under "Experimental Procedures." 26 h later, cells were UV irradiated (10 J/m2), and at various times after treatment, p53 reporter expression was measured. Results show the average beta -galactosidase activity ± S.E. for three independent transfections at various times after UV treatment. The experiment was performed twice with similar results.

We next examined the effect of HBx expression on DNA repair. First, we tested the ability of wild-type and p53-null hepatocytes transiently transfected with the HBx expression vector to repair a reporter plasmid damaged by various doses of UV-C. There was a dose-dependent impairment of the recovery of the reporter expression, and this was not affected by the p53 genotype (Fig. 4), as noted previously (21). No differences were observed between cells transfected with pCMV-x1 or with the control plasmid, suggesting that HBx does not affect this type of repair (Fig. 4).


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Fig. 4.   Host reactivation of a damaged plasmid. Hepatocytes previously transfected with the HBx expression vector (pCMV-x1) or with a control plasmid were cotransfected with an undamaged pCMVbeta plasmid and a CAT reporter plasmid damaged with the indicated doses of UV-C (0, 500, 1,000 J/m2) as described under "Experimental Procedures." The CAT activities 24 h after transfection, corrected according to the transfection efficiency, are given relative to the activity of an untreated plasmid transfected under the same conditions. The figure shows the average CAT activity from three independent transfections. The experiment was performed twice with similar results.

Second, we quantified the unscheduled DNA synthesis in these cells, transiently transfected or not with the HBx expression vector. This was measured by image analysis of grain density after autoradiography of cultures treated with different doses of UV and subsequently allowed to incorporate tritiated thymidine. In the absence of UV irradiation the majority of the cells presented a low nuclear grain index (between 0 and 5), and a second group of cells exhibited a nuclear grain index >40, representing cells undergoing DNA synthesis. After UV irradiation, the grain index was increased in hepatocyte nuclei regardless of genotype, showing that the cells were initiating unscheduled DNA synthesis (Fig. 5). However, the grain index of irradiated p53-/- cells was significantly less than wild-type cells (mean ± S.E. are 23.5 ± 1.08 and 10.6 ± 0.47 for wild-type and p53-null hepatocytes, respectively). Transfection of the HBx-expressing plasmid in p53-null cells had no significant effect (mean ± S.E. are 10.6 ± 0.47 for untransfected versus 11.6 ± 0.50 for pCMV-x1-transfected hepatocytes), whereas in wild-type cells, expression of HBx resulted in a decreased grain index (10.9 ± 0.57 and 23.5 ± 1.08 for transfected and nontransfected, respectively) to a level similar to that found in p53-null cells. Hence, HBx expression reduces unscheduled DNA synthesis of wild-type cells to the level of p53-null cells but does not further alter the unscheduled DNA synthesis activity of p53-null cells. Taken together, these results indicate that HBx affects p53-dependent repair, i.e. global repair, especially the repair of the CPDs.


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Fig. 5.   Unscheduled DNA synthesis. Unscheduled DNA synthesis was quantified as described under "Experimental Procedures" in hepatocytes treated with 0 or 20 J/m2. The figure represents the proportion of cells of different grain index for primary hepatocytes transfected with a control plasmid (black columns) and with the HBx expression vector (dotted columns). Cells with a grain index higher than 40 are undergoing replicative DNA synthesis.


    DISCUSSION
Top
Abstract
Introduction
Procedures
Results
Discussion
References

Interspecies differences in the level of DNA repair are well described; mouse fibroblasts typically show a lower efficiency of global repair than human fibroblasts (33, 34). The present observation that DNA repair efficiency is relatively high in mouse hepatocytes, indeed approaching the level of human fibroblasts, suggests that nuclear excision repair is particularly important in this cell type. This observation, in association with our previous demonstration that hepatocytes do not readily undergo apoptosis in response to DNA damage (20), suggests an emphasis on repair mechanisms rather than self-deletion after DNA damage. This is consistent with known detoxifying roles of hepatocytes during which genotoxic metabolites are likely to be generated. Indeed, mice deficient in the nucleotide repair protein XPA (35) develop spontaneous HCC, and ERCC1 (for excision repair cross-complementing 1) deficiency causes mice to die soon after birth with an unusual liver pathology associated with nuclear p53 accumulation (36). The p53 protein is important in regulating various responses to DNA damage, including cell cycle arrest, apoptosis, and DNA repair, and these responses differ among cell types. We have reported previously that in DNA-damaged hepatocytes, p53 regulates cell cycle arrest but not apoptosis (20). We show here, in agreement with reports in human fibroblasts (29, 31, 32), that p53 is required for efficient global repair, especially the repair of the CPDs, but not for transcription-coupled repair. Taken together, these data strongly suggest that DNA repair is a critical process in hepatocytes and, at least partially, depends on p53.

Interestingly, although the precise mechanisms by which the carcinogenic viral protein HBx promotes the development of HCC remain unclear, there is good evidence that interaction with and functional disruption of p53 are important. The present data show that HBx expression reduces p53 transactivation of a reporter plasmid after irradiation, and this is direct evidence that HBx alters endogenous p53 responses to DNA damage in liver cells. Moreover, we showed that the p53-dependent component of hepatocyte DNA repair is also inhibited by HBx. Indeed, HBx expression in wild-type cells reduces global DNA repair to the level of untransfected p53-null hepatocytes. By contrast, HBx expression did not further affect global repair in p53-null cells or the repair of a damaged plasmid (host cell reactivation assays) which we previously demonstrated to be p53-independent in hepatocytes (21). The precise mechanism by which HBx interferes with p53-dependent regulation of repair was not evaluated here but may involve direct binding of HBx to p53 (17, 18, 37). This interaction was identified in vivo by coprecipitation of HBx and p53 from liver tumors (19) and could produce cytoplasmic sequestration of p53 (17, 18, 37) or interference with p53 transcriptional regulation of other downstream proteins involved in nuclear excision repair (25 and references therein). The interaction of HBx with p53 could also inhibit p53 binding to the repair proteins XPB and XPD as was seen previously using cell extracts (25). It is therefore likely that direct interaction of HBx with p53 is central to the p53-dependent effect of HBx on DNA repair observed here. In a recent report, Becker et al. (38) used several HBx deletion mutants to identify regions of HBx required for impairment of DNA repair. They found a minimal region that correlates with the region interacting with the repair protein XAP-1/UV-DDB. However, this part of HBx protein is also required for p53 binding (39). It is therefore difficult to rule out the possibility that the inhibition of DNA repair observed in their study was dependent on HBx interaction with p53.

Clearly, if HBx alters p53-dependent DNA repair through binding to p53, it could affect other p53-regulated functions such as p53-dependent apoptosis. Indeed, HBx expression inhibited p53-dependent apoptosis in hepatocytes when apoptosis was produced by microinjection of a p53-overexpressing vector (37, 40). Under the present culture conditions where apoptosis is not p53-dependent (20), transient expression of HBx has no effect on hepatocyte apoptosis, as might be expected. Direct binding of HBx to p53 could also explain the inhibition of p53 transactivation function, either by sequestering p53 protein in the cytoplasm (37) or by altering p53 binding to DNA (15, 16, 39) or to proteins of the transcription machinery (25, 41). Inhibition of p53 transactivation function by HBx has been reported in cells coinjected or cotransfected with p53 and HBx expression vectors (15, 16). The present report extends these studies to show interference by HBx with the transactivation responses to a physiological level of endogenous p53.

Implication for Human Liver Carcinogenesis-- Numerous biological properties for HBx have been described which could account for its role in hepatocarcinogenesis. The present work supports the idea that dysfunction of the p53 protein through interaction with HBx is of biological and pathological significance for early events leading to carcinogenesis. In our experiments, HBx expression mimics a state of p53 deficiency or of inactivating p53 mutation. Hence p53 mutation may be unnecessary for carcinogenesis in HBV-infected hepatocytes that express HBx. Indeed, clinical studies have shown an association between HBx expression and the absence of mutation in p53 (8, 42), and by contrast, HCC carrying p53 mutations does not express HBV products (8, 42). Moreover, there is an abnormal accumulation of p53 protein in the hepatocytes of patients with viral-induced cirrhosis (8, 10, 19), and HBV-associated HCC has a low frequency of p53 mutation in non-AFB1-exposed populations (8, 10, 19, 43-45). These observations, together with others suggesting that the p53 mutation and loss of allele are late events in this type of cancer (7-11), strongly support the in vitro data suggesting that HBx inactivation of p53 functions is an authentic alternative mechanism to p53 mutation in early carcinogenesis.

Chronic viral hepatitis is characterized by a regenerative necroinflammatory process, typically sustained for several years. Hepatitis-related cycles of cell death and regeneration in an inflammatory environment, conditions that favor the generation of reactive oxygen species, could be critical for a progressive accumulation of genetic defects. If, as suggested here, HBx impairs p53-dependent DNA repair, then two predictions can be made. First, mutation incidence should be increased by HBx expression. Second, because p53 affects global repair but not transcription-coupled repair, an increased incidence of mutation in the nontranscribed strand would be expected in patients with HBV infection. Interestingly, HBx infection further increases the mutation rate in patients from areas with high dietary exposure to aflatoxin (46), and furthermore, p53 mutations in hepatocellular carcinomas of patients from regions where HBV is endemic show a strong bias toward the nontranscribed strand (47).

Taken together with the present demonstration that DNA repair is a very efficient process in normal hepatocytes, these data indicate that alteration by HBx of p53-dependent DNA repair could promote hepatocarcinogenesis. This has implications for our understanding of the ways in which HCC arises in chronic inflammatory liver disease and possibly for the investigation of new treatments. Indeed, there are additional properties of both HBx and p53 which will be interesting to evaluate in hepatocytes: we have shown that p53 maintains hepatocyte sensitivity to cytokines that promote growth and survival (20). There are reports that HBx expression alters hepatocyte responses to cytokines (48-53), and it is possible that these observations also reflect an effect through p53. This possibility together with our finding that deficiency in IRF-1 (21), a regulator of cellular responses to cytokines, leads to a reduction in DNA repair, could have implications for how antiviral treatments with cytokines might alter hepatocyte repair efficiency.

    ACKNOWLEDGEMENTS

Many thanks to Prof. S. Friend who gave us the p53 reporter plasmid pRGCDelta FosLacZ, Prof. Curtis C. Harris and Dr. X.W. Wang for the HBx expression vector pCMV-x1, and Dr. T. Mori for the TDM-2 and 64M-2 antibodies.

    FOOTNOTES

* This work was supported by the Scottish Hospital Endowments Research Trust, the Melville Trust (Edinburgh), and the NCI, National Institutes of Health.The costs of publication of this article were defrayed in part by the payment of page charges. The article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.

Dagger To whom correspondence should be addressed: Dept. of Pathology, University Medical School, Teviot Place, Edinburgh, EH8 9AG, Scotland. Tel.: 44-131-650-2917; Fax: 44-131-650-6528; E-mail: s.prost{at}ed.ac.uk.

The abbreviations used are: HBV, hepatitis B virus; HCC, hepatocellular carcinoma; HBx, hepatitis B x protein; CMV, cytomegalovirus; CAT, chloramphenicol acetyltransferase; DHFR, dihydrofolate reductase.
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Top
Abstract
Introduction
Procedures
Results
Discussion
References

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