Stimulation of Inducible Nitric Oxide by Hepatitis B Virus Transactivator Protein HBx Requires MTA1 Coregulator*

Nitric oxide has been implicated in the pathogenesis of inflammatory disorders, including hepatitis B virus-associated hepatocellular carcinoma. Transactivator protein HBx, a major regulator of cellular responses of hepatitis B virus, is known to induce the expression of MTA1 (metastasis-associated protein 1) coregulator via NF-κB signaling in hepatic cells. However, the underlying mechanism of HBx regulation of the inducible nitric-oxide synthase (iNOS) pathway remains unknown. Here we provide evidence that MTA1 is a positive regulator of iNOS transcription and plays a mechanistic role in HBx stimulation of iNOS expression and activity. We found that the HBx-MTA1 complex is recruited onto the human iNOS promoter in an NF-κB-dependent manner. Pharmacological inhibition of the NF-κB signaling prevented the ability of HBx to stimulate the transcription, the expression, and the activity of iNOS; nevertheless, these effects could be substantially rescued by MTA1 dysregulation. We further discovered that HBx-mediated stimulation of MTA1 is paralleled by the suppression of miR-661, a member of the small noncoding RNAs, recently shown to target MTA1. We observed that miR-661 controls of MTA1 expression contributed to the expression and activity of iNOS in HBx-expressing HepG2 cells. Accordingly, depletion of MTA1 by either miR-661 or siRNA in HBx-expressing cells severely impaired the ability of HBx to modulate the endogenous levels of iNOS and nitrite production. Together, these findings reveal an inherent role of MTA1 in HBx regulation of iNOS expression and consequently its function in the liver cancer cells.

In the past decade, a number of epidemiological studies have suggested that up to 75% of hepatocellular carcinoma (HCC) 2 cases are associated with either chronic hepatitis B virus (HBV) or hepatitis C virus (1)(2)(3)(4). Although nonstructural hepatitis B virus transactivator protein-HBx, a pivotal regulatory protein of HBV, was intimately linked to the pathogenesis of HBV infection, a comprehensive view of HBx in oncogenesis remains to be fully understood (5)(6)(7)(8). HBx modulates a wide range of cytoplasmic and nucleus gene products with diverse functions and affects virtually every single known signaling pathway (9,10). HBx has also been implicated in inflammatory response in chronic HBV infection during HCC developments (11). Specifically, HBx activates NF-B signaling (12,13) and enhances the expression of its downstream inflammatory targets, including inducible nitric-oxide synthase (iNOS) (9, 14 -16). Inducible NOS is both an NF-B-responsive (17)(18)(19)(20) and an HBx-regulated gene (14). Inducible NOS generates nitric oxide (NO) from L-arginine. Nitric oxide modifies DNA, proteins, and lipids or interacts with transition metals and free radical residues in a variety of cell types, including macrophages and hepatocytes (8), and participates in processes leading to inflammation and tumorigenesis. In addition to studies suggesting the prominent correlation between high levels of iNOS expression and acute and chronic hepatitis B (21,22), Kane et al. (23) have shown that increased levels of nitrate and N-nitroso carcinogenic compounds are associated with DNA mutagenesis in chronic hepatitis C virus infection. Interestingly, NO also mediates the antiviral activity by inhibiting the replication of HBV and lymphocytic choriomeningitis virus (24). Thus, the contribution of NO in hepatic pathology is not firmly defined as of yet due to the dual role of NO in cancer biology (25). MTA1 (metastatic tumor antigen 1), a component of nuclear remodeling histone deacetylate complex, is also modulated by HBx in liver cancer cells (26). MTA1 plays significant roles in both tumor biology and inflammation. High expression levels of MTA1 have often been found in the later stages of cancer. Most notably, MTA1 was overexpressed in the cancers of gastrointestinal tract origin, ranging from esophageal squamous cell carcinomas to gastrointestinal carcinoma, colorectal carcinoma, and hepatomas (27,28). In hepatectomy HCC patients, MTA1 status was proposed to be a potential prognostic indicator because elevated MTA1 levels in HBV-associated HCC appeared to be associated with shorter median survival rates as compared with those of MTA1-negative HCC patients (29). A recent report from our laboratory reaffirms the positive correlation between the levels of MTA1 and HBx as well as between the expression of NF-B-p65 and HBx in human HCC specimens (30).
In recent years, microRNAs (miRNAs) have gradually assumed an important position in gene regulation studies. MicroRNA, a small RNA with an average length between 18 and 23 nucleotides, is involved in a gamut of cellular processes, including cell differentiation, apoptosis, neoplasia, develop-ment and pathophysiological events, such as host-virus interaction, viral oncogenesis, and tumorigenesis (31)(32)(33). For example, cellular miRNAs have been demonstrated to target foreign nucleic acids of the viruses (e.g. primate foamy virus, human immunodeficiency virus, and influenza virus) (32,34). MicroRNA also acts as a post-transcriptional modifier of the target gene regulation (35). In one of the studies, human miRNA-661 compromises the MTA1 functions in physiological settings, leading to substantial reduction in the motility, invasiveness, and anchorage independence of breast cancer cells (36). Clearly, MTA1 is the common target of both HBx and miRNA-661 in cancer pathology; however, a possible cross-talk between HBx and miR-661 in HCC remains largely undefined.
Here we investigated the molecular insights by which HBx stimulates the iNOS pathway. Findings presented in the study reveal a previously unrecognized mechanism of how HBx regulates iNOS transcription, involving a mandatory role of the MTA1-NF-B pathway. Additionally, we also demonstrated that HBx-mediated up-regulation of MTA1 is accompanied by the inhibition of its upstream regulator, miR-661. These findings provide a positive causal relationship among the various components of the HBx-miR-661-MTA1-iNOS pathways, all contributing to the development of cancerous phenotypes in the liver cells.

EXPERIMENTAL PROCEDURES
Cell Cultures and Materials-The HepG2 human hepatocellular carcinoma cell line was obtained from the American Type Culture Collection (Manassas, VA). Murine embryonic fibroblasts (MEFs) (wild type), MTA1 Ϫ/Ϫ MEFs, and HepG2 were cultured as described previously or otherwise stated (37,38). Briefly, cells were maintained at 37°C in Dulbecco's modified Eagle's medium/F-12 medium supplemented with 10% fetal bovine serum, 2 mM glutamine, and antibiotics. Full-length pSG5-HBx and pSG5-HBx mutant constructs were the kind gift of Dr. Vijay Kumar (Virology Group, International Centre for Genetic Engineering and Biotechnology, India). pCMV-HBx was a kind gift from Dr. Aleem Siddiqui (University of Colorado Health Sciences, Denver, CO). Rabbit polyclonal anti-HBx was a gift from Dr. Betty L. Slagle (Department of Molecular Virology and Microbiology, Baylor College of Medicine, Houston, TX).
Quantitative PCR to Quantify RNA/miRNA Expression-HepG2 cells were transfected with pSG5-HBx or control pSG5 vector by FuGene 6 (Roche Applied Science). After 48 h, the cells were harvested, and total RNA was prepared by the TRIzol method (Invitrogen). Real time PCR was performed to measure the miR-661 levels using miRNA-specific probes (AB Systems, Foster City, CA). U6 RNA was used as an internal control. Firststrand cDNA synthesis was carried out with SuperScript II reverse transcriptase (Invitrogen) using 2 g of total RNA and poly(dT) primer. cDNA was synthesized using the FastLane Cell cDNA kit (Qiagen, Valencia, CA). Quantitative reverse transcription-PCR was performed with the gene-specific primers listed in supplemental Table 1. Quantitative reverse transcription-PCR was performed using a 7900HT sequence detection system (Applied Biosystems, Foster City, CA). The levels of mRNA for tested targets were normalized to that of ␤-actin mRNA to quantify for the relative levels of MTA1 mRNA or HBx mRNA. An amplicon specific to iNOS was used to assess the number of iNOS mRNA copies in the experiment.
EMSA-Nuclear extracts were prepared using a Nonidet P-40 lysis method (39). EMSA for DNA binding was performed using the annealed and [␥-32 P]ATP end-labeled iNOS PCR fragment generated by primers specific to the (Ϫ1 to Ϫ246) region in a 20-l reaction mixture for 15 min at 20°C. Samples were resolved on a nondenaturing 5% polyacrylamide gel and imaged by autoradiography. Supershift complex was detected by the addition of 1 g of antibodies.
siRNA/miRNA Transfection-siRNA against MTA1, negative control siRNA, miR-661, and control negative mimics miRNA were obtained from Dharmacon (Lafayette, CO). Cells were seeded at 40% density 24 h prior to transfection in 6-well plates. Transfection was performed using Oligofectamine (Invitrogen) according to the manufacturer's instructions. Cells were subsequently subjected to further studies after 36 h of transfection. Western blot analyses were performed as described previously (38) to determine the levels of ␤-actin, vinculin (Sigma), NOS-2 (Santa Cruz Biotechnology, Inc., Santa Cruz, CA), MTA1 (Bethyl Laboratories, Montgomery, TX), and HBx (a rabbit polyclonal anti-HBx, a kind gift from Dr. Betty L. Slagle) for transfection efficiency.
ChIP and Reporter Assays-HepG2 cells were transiently transfected with HBx expression vector prior to ChIP analysis and reporter assays. Chromatin immunoprecipitation assays were done by using FLAG antibody (F3165, Sigma) and MTA1 antibodies as described previously (38,40). The primers used for ChIP are listed in supplemental Table 1. iNOS-luciferase and MTA1 3Ј-UTR-luciferase assay were performed according to the manufacturer's instructions (Promega, Madison, WI), and the results were normalized against the ␤-galactosidase activity, an internal control.
Assay of Nitrite-Nitrite levels obtained from the conditioned media were measured by an HPLC-UV system (ENO-10, NOD-10) (EICOM, Kyoto, Japan) using Griess's method (41). Briefly, conditioned medium fractions were deproteinized with an equal volume of methanol and subjected to centrifugation at maximum speed at room temperature. Samples were injected into the HPLC-UV system for analysis for a 10-min intervals. Nitrite levels were assayed at 4 min after the injection. Detection was measured at 540 nm (absorption), and the concentrations were calculated from the area under the curve of each aliquot of NaNO 2 (PowerChrome, EICOM, Kyoto). Nitrite levels were presented as nM/10 5 cells.
Statistical Analysis and Reproducibility-The results are given as the means Ϯ S.E. Statistical analysis of the data was performed by using Student's t test or as otherwise described.

RESULTS
HBx Targets miR-661 to Up-regulate MTA1 Expression-Yoo et al. (26) have demonstrated the ability of HBx to induce MTA1 in HCC and a potential positive correlation between the levels of HBx and MTA1 in HCC. A recent study aimed at elucidating the underlying mechanisms of MTA1 up-regulation in HBx-expressing cells has further revealed an essential role of MTA1 in HBx regulation of NF-B signaling, which is vital for HBV-mediated hepatocarcinogenesis (30). Because an emerging notion suggests that viruses may evade the host defense mechanism by suppressing RNA-mediated silencing (33), the possibility that viral protein may utilize a similar strategy to induce essential cancer relevant proteins prompted us to evaluate the effects of HBx on the status of specific miRNAs. In this context, we examined the impact of HBx on the levels of miR-661, a known inhibitor of MTA1 that targets the 3Ј-UTR of MTA1 mRNA (36). Increasing doses of HBx resulted in increasing MTA1 levels but a marked reduction in miR-661 in HBx transfected cells (Fig. 1A). The observed inhibitory effect of HBx on miR-661 levels appears to be selective as there was albeit or no change in the level of hsa-miR7 (supplemental Fig.  S1). Interestingly, there was no effect of HBx upon the miR-661 promoter luciferase activity (data not shown). In addition, there was not detectable recruitment of HBx protein to the upstream 2-kb DNA region of the putative miR-661 promoter by ChIP analysis (supplemental Fig. S2). In contrast, HBx effectively stimulated the activity of MTA1 3Ј-UTR-luc reporter in HepG2 cells (Fig. 1B), presumably due to the down-regulation of miR-661. The results suggest a possible mechanism by which HBx regulates MTA1 expression levels via modulation of miR-661 levels.
Regulation of iNOS by miR-661-MTA1 Pathway-A recent study from our laboratory (30) has established that MTA1 depletion in HepG2 cells impairs the ability of HBx to induce expression of NF-B target genes. Because iNOS, which has been previously implicated in the pathogenesis of HBV-associated HCC (42), is one of the downstream targets of NF-B, we next wished to investigate the role of miR-661 in HBx regulation of iNOS. To this end, we first confirmed the ability of HBx to induce iNOS mRNA by quantitative real-time PCR in our HepG2 cells. We found that up-regulation of iNOS (and MTA1 as a positive control) by HBx was transcriptional in nature because it could be effectively blocked by actinomycin D, an RNA transcription and DNA replication inhibitor (supplemental Fig. S3). To examine the effects of miR-661 in HBx-transfected cells, HepG2 cells were cotransfected with HBx and miR-661 or control (designated miR-con) miRNA mimic, and the levels of iNOS proteins were determined by Western blotting. Additionally, transfection efficiency of miR-661 was also evaluated by quantitative reverse transcription-PCR (Fig. 2, B and E). As expected, miR-661-mediated depletion of MTA1 significantly attenuated the effect of HBx to induce iNOS protein as  Effects of miR-661 on HepG2 cells expressing HBx. HepG2 cells were transfected with 100 nmol of either miR-661 or negative control mimic (Dharmacon, Lafayette, CO) using Oligofectamine (Invitrogen). After 24 h, transfected HepG2 cells were again subjected to co-transfection with either control vector or HBx (250 ng/reaction in a 6-well plate) and iNOS promoter reporter construct. A and B, cell lysates were subjected to Western blot analysis for iNOS, HBx, and MTA1 expression. Vinculin was used as a loading control. Transfection efficiency of miR-661 in HepG2 cells was evaluated by quantitative real time PCR. U6 RNA was used as an internal control for miR-661 quantification. C, MTA1 ectopic expression rescued miR-661 effects. iNOS promoter luciferase assay was performed 48 h after HBx transfection. MicroRNAtransfected HepG2 cells were subsequently co-transfected with HBx and pcDNA-MTA1-T7-tagged or control expression vector (500 ng/reaction in a 6-well plate) (n ϭ 3). Results are presented in -fold change compared with control, mean Ϯ S.E., n ϭ 3. D and E, cells were subjected to Western blot analysis for iNOS and MTA1 expression. T7 tag was analyzed for transfection efficiency. ␤-Actin was used as an internal control. E, transfection efficiency of miR-661 in HepG2 cells being transfected with miRNA-661, HBx, and MTA1 expression vector was evaluated by quantitative real-time PCR. U6 RNA was used as an internal control for miR-661 quantification. F, conditioned medium at the time of harvesting was collected and assayed for nitrite levels as described under "Experimental Procedures." The levels of nitrite accumulation/10 5 cells are presented as mean Ϯ S.E. All experiments were repeated at least three times. compared with that of the cells transfected with miR-con ( Fig.  2A). Likewise, miR-661 also reduced the transcription driven from the iNOS promoter despite the presence of a detectable level of HBx protein (Fig. 2C). To establish the impairment of iNOS biologic activity in HBx-expressing HepG2 cells, we next demonstrated that miR-661-mediated inhibition of iNOS expression, presumably due to inhibition of MTA1, was accompanied by a corresponding decreased accumulation of nitrite, the downstream product of iNOS (Fig. 2F). To validate these finding, we examined whether these inhibitory effects of miR-661 on the expression and activity of iNOS induced by HBx could be rescued, at least in part, by MTA1 overexpression. We found that the co-expression of MTA1 could partially reverse the inhibitory effects of miR-661 on the levels of iNOS promoter activity, protein expression, and its biologic activity as measured by the levels of nitrite, an index of iNOS activity (Fig.  2, C, D, and F, respectively). Collectively, results from Figs. 1 and 2 suggest that HBx targets miR-661, an endogenous regulator of MTA1, and that HBx regulation of the iNOS pathway requires MTA1.
HBx Stimulation of iNOS Requires MTA1-To validate the finding that MTA1 may play an essential role in HBx transactivation of iNOS expression, we examined how changes in HBx and/or MTA1 levels affect iNOS. We found that MTA1 by selectively knocking down MTA1 using an siRNA approach drastically reduced the ability of HBx to stimulate iNOS transcription (Fig. 3A) and protein levels (Fig. 3B). To understand the significance of endogenous MTA1 on the transactivation activity of HBx, we next examined the ability of HBx to induce iNOS promoter luciferase activities in MTA1 knockdown HepG2 cells cotransfected with HBx and iNOS promoter luciferase reporter. Results in Fig. 4 illustrate that MTA1 depletion (Fig. 4A) compromised the iNOS transactivation activity of HBx (Fig. 4B). To independently validate these results, an iNOS promoter study was carried out in MEFs from the wild type and MTA1-knock-out mice. We found that HBx is unable to induce iNOS promoter luciferase activities in MTA1-knock-out MEFs, whereas it did so in the wild type MEFs (Fig. 4C). As expected, MTA1 deficiency in MEFs led to reduction in iNOS protein expression levels (Fig. 4D). Together, these studies establish the notion that MTA1 is an essential mediator of HBx transactivation of iNOS activities. (17,18) suggests that an NF-B protein complex was recruited to the NF-B response elements located in the iNOS gene promoter. To gain a detailed insight into the mechanism by which HBx regulates iNOS via MTA1, we analyzed the upstream 8.5-kb region of the putative iNOS promoter for the presence of binding motifs of NF-B. This analysis revealed that five binding sites harbored consensus motifs for NF-B within the Ϫ1 to Ϫ246, Ϫ5344 to Ϫ5593, Ϫ5707 to Ϫ5941, Ϫ6010 to Ϫ6223, and Ϫ8100 to Ϫ8296 from the transcriptional initiation site of iNOS (Fig. 5A). An earlier study (30) has demonstrated the interaction between HBx and NF-B-p65, so we next examined the recruitment of the HBx-MTA1 protein complex to the iNOS promoter chromatin. Results from a ChIP-based iNOS promoter walk in the HepG2 cells expressing HBx showed the recruitment of HBx or MTA1 to all NF-B consensus motifs with the exception of the Ϫ6010 to Ϫ8296 regions. However, using sequential ChIPs involving HBx, followed by MTA1, we found that the HBx-MTA1 complex was recruited only onto two distinct regions (Ϫ1 to Ϫ246 and Ϫ5344 to Ϫ5593) of the iNOS promoter. Such recruitment could be effectively reduced by the inclusion of NF-B-inhibitor parthenolide, suggesting the involvement of NF-B proteins in the noted recruitment of the HBx-MTA1 complex to the iNOS promoter (Fig. 5B). To independently validate this finding, we next investigated whether cellular HBx-MTA1 complex could interact with the iNOS DNA. The nuclear extracts from the HepG2 cells transfected with HBx were subjected to EMSA analysis using a DNA fragment of the iNOS promoter (Ϫ1 to Ϫ246) region containing a single NF-B consensus motif. We found that extracts from the HBx-expressing but not the control-expressing HepG2 cells formed a distinct protein-DNA complex (Fig. 5C, compare lane 5 with lane 2). The observed protein-DNA complex could be effectively supershifted by anti-MTA1 antibodies but not by IgG (compare lane 6 with lane 7). In contrast, extract from control-expressing cells could neither form protein-DNA complex nor induce an expected supershift in the presence of MTA1 antibodies. Interestingly, the inclusion of parthenolide impeded the formation of protein-DNA complex as well as its supershift by the MTA1 antibodies (lanes 8 -13). Because previous studies have suggested that HBx cannot directly bind to chromatin, these results further suggest that HBx presumably forms an intricate complex with NF-B proteins and MTA1 to interact with the iNOS DNA fragment in the EMSA. Collectively, these observations indicate that HBx-MTA1-NF-B proteins are recruited to the iNOS promoter, leading to active transcription by HBx in liver cancer cells.

Molecular Insights of HBx-MTA1 Transactivation of iNOS Chromatin-Previous studies
HBx Utilizes MTA1-NF-B Pathway to Stimulate iNOS-To validate the putative essential role of MTA1 in HBx stimulation of the iNOS activity, we examined whether the inhibitory property of pathernolide on HBx-induced NF-B activities could be rescued by ectopic MTA1. Results shown in Fig. 6 indicated that ectopically expressed MTA1 not only overcame the inhibitory effect of pathernolide on iNOS promoter activity but also increased the promoter activity compared with that in the control cells (Fig. 6A). As expected, parthernolide inhibited the expression of MTA1 and iNOS gene products (Fig. 6B) could be rescued by ectopic MTA1. In parallel, the expression also increased the levels of nitrite compared with the controls (Fig.  6C). Altogether, these findings illustrate a pivotal role of MTA1 in HBx transactivation of iNOS, presumably by modulating the status of the NF-B pathway.

DISCUSSION
Although myriad studies have suggested the important roles of MTA1 and iNOS in carcinogenesis and metastasis, especially in HCC and chronic liver diseases, only a few studies have provided the initial mechanistic insights into how HBx transduces  iNOS activity. Studies from our laboratory have addressed the roles of MTA1, the founding member of the nuclear remodeling histone deacetylate family of coregulators, in HBx stimula-tion of the NF-B signaling (30). MTA1 has been intimately linked with HCC and is widely regarded as a potential master coregulator. Interestingly, the possible linkage between coincidental high expression levels of MTA1 and iNOS in HCC has not hitherto been addressed. Here, by demonstrating a novel mechanism in which HBx stimulates iNOS transcription via MTA1, we intercalate an intermediate layer of regulation that is essential to HBx transduction of the iNOS activity. In addition, during examination of the regulation of the iNOS promoter under the influence of HBx, we showed that HBx may regulate iNOS indirectly. In this scenario, HBx regulates MTA1 by targeting miR-661, a microRNA recently shown to target MTA1 expression.
Over the years, a number of downstream targets of MTA family have dramatically increased; nevertheless, knowledge about the upstream regulators of MTA1 continues to be limited. For example, MTA1 has been shown to be up-regulated by heregulin ␤-1, hypoxia, c-Myc (28), and NF-B signaling (30). In this context, it is worth mentioning that miR-661, a human miRNA, and miR-559, a mouse miRNA, can down-regulate MTA1 (36). Initial utilization of miR-661 as a tool to study the role of MTA1 in HBx transactivation iNOS led to a unique discovery that HBx targets miR-661 to regulate the level of MTA1. This is particularly novel because miR-661 was able to control the expression of iNOS in a manner that is dependent on MTA1 or could be rescued by MTA1 overexpression. Our observation that HBx inhibits miR-661 level is important because, in most cases, cellular miRNA acts as a defense mechanism against viruses by restricting viral accumulation or targeting viral nucleic acids/genes (32). For example, hepatitis C virus utilizes cellular miRNA to target the 5Ј-UTR of the viral genome, leading to RNA accumulation (43). In contrast, we showed that HBV core protein regulates MTA1, an essential component for HBV transactivation, by targeting cellular miRNA activity. Interestingly, although the levels of miR-661 transcript were dramatically reduced by HBx, the miR-661 promoter study did not show any notable change (data not shown), suggesting that HBx might affect the levels of miR-661 by modulating the stability of miR-661. Consistent with these observations, ChIP analysis did not show any recruitment of HBx to the miR-661 promoter. Clearly, additional work will be needed to precisely define the mechanism by which HBx regulates miR-661 levels. Nevertheless, because our interest is the mechanistic insight of iNOS regulation, in the present studies, we have provided conclusive evidence showing the important role of MTA1 in regulating the generation of NO in HBx-expressing cells.
Nitric oxide is known for its roles in homeostasis regulation and defense mechanism; its effects on carcinogenesis and tumor progression, however, remain far from clear due to its dual role in tumor biology. Nevertheless, overexpression of iNOS under chronic inflammatory conditions is known to induce genotoxicity. Additionally, iNOS affects multiple stages of cancer progression by modulating tumor cell growth, regulating angiogenesis, and enhancing tumor vasculature permeability (44 -47), as evidenced by increased angiogenesis and tumor growth in a mouse model of the constitutively secreted NO cell line (47). In human cohort studies, strong association between tumor grade of breast and gynecological cancers and FIGURE 6. Ectopically expressed MTA1 rescued inhibitory effects of parthernolide. A, HBx-expressing HepG2 cells were treated with parthernolide and subsequently transfected with pcDNA-MTA1 control expression vector (500 ng/reaction in a 6-well plate). Cells were then subjected to an iNOS promoter assay. B, subsequently, cell lysates were subjected to Western blot analysis for iNOS expression. Western blot analysis for HBx and T7 tag was carried out for transfection efficiency. Vinculin was used as a loading control. C, the levels of nitrite accumulation/10 5 cells are presented as mean Ϯ S.E., n ϭ 3.
NO production was observed (48,49). In HCC patients, wherein intrahepatic invasion and metastasis are the major causes of failure, not only do nitrite and nitrate levels significantly increase with positive immunohistochemical staining of iNOS, but tumor volumes also positively correlate with the generation of NO (50). This suggests that the liver-derived high level of NO may participate in the carcinogenesis and progression of HCC. Therefore, elucidating the mechanism underlying HBx induction of iNOS provides the crucial piece of information to the etiology of HBx-associated HCC. Furthermore, liver carcinogenesis depends on the magnitude of NF-B activity (51). In this context, we have found that HBx-stimulated iNOS activities were effectively attenuated by parthernolide, an NF-B inhibitor, and thus highlight the significance of the NF-B pathway in this process. These discoveries further corroborate the aforementioned studies, suggesting a mechanistic role of NF-B in liver cancer progression. Together, these findings reveal an inherent role of MTA1 in HBx regulation of iNOS expression and consequently its function in the liver cancer cells.