Cytokine levels contribute to the pathogenesis of minimal hepatic encephalopathy in patients with hepatocellular carcinoma via STAT3 activation

Sci Rep. 2016 Jan 13:6:18528. doi: 10.1038/srep18528.

Abstract

Hepatocellular carcinoma (HCC) patients were grouped according to the degree of encephalopathy, with healthy volunteers as controls. We investigated clinical presentation, protein and mRNA expression of 14 cytokines, and activation of six STAT proteins, the downstream signaling mediators. Levels of all 14 cytokines were significantly elevated in HCC patients with clinical hepatic encephalopathy. Statistical analysis showed that levels of IL-1β, IL-6, IFNγ, IL-17α, IFNλ2 and IFNλ3 were correlated with minimal hepatic encephalopathy (MHE). Multivariate regression analysis identified serum IL-6, IFNλ3 and IL-17α as independent risk factors for MHE. Increased mRNA levels of IL-6 and IFNγ were associated with MHE. Among the STAT proteins examined, only STAT3 was elevated in MHE. Treatment with a STAT3 inhibitor protected neurons from cytokine-induced apoptosis in vitro. In conclusion, this study identified potential biomarkers for MHE in HCC. The cytokines investigated may induce neural apoptosis via STAT3 in the pathogenesis of MHE in HCC.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Apoptosis
  • Biomarkers
  • Biopsy
  • Carcinoma, Hepatocellular / complications*
  • Carcinoma, Hepatocellular / diagnosis
  • Carcinoma, Hepatocellular / metabolism*
  • Case-Control Studies
  • Cytokines / blood*
  • Female
  • Hepatic Encephalopathy / blood*
  • Hepatic Encephalopathy / diagnosis
  • Hepatic Encephalopathy / etiology*
  • Humans
  • Liver Neoplasms / complications*
  • Liver Neoplasms / diagnosis
  • Liver Neoplasms / metabolism*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Prognosis
  • STAT3 Transcription Factor / metabolism*
  • Tomography, X-Ray Computed

Substances

  • Biomarkers
  • Cytokines
  • STAT3 Transcription Factor