Summary Epidemiological studies indicate that overweight and obesity are associated with increased cancer risk. To study how obesity augments cancer risk and development, we focused on hepatocellular carcinoma (HCC), the common form of liver cancer whose occurrence and progression are the most strongly affected by obesity amongst all cancers. We now demonstrate that either dietary or genetic obesity is a potent bona fide liver tumor promoter in mice. Obesity-promoted HCC development was dependent on enhanced production of the tumor promoting cytokines IL-6 and TNF, which cause hepatic inflammation and activation of the oncogenic transcription factor STAT3. The chronic inflammatory response caused by obesity and enhanced production of IL-6 and TNF may also increase the risk of other cancers.

Sestrins are conserved proteins that accumulate in cells exposed to stress and potentiate adenosine monophosphate-activated protein kinase (AMPK) and inhibit activation of target of rapamycin (TOR). We show that abundance of Drosophila Sestrin (dSesn) is increased upon chronic TOR activation through accumulation of reactive oxygen species (ROS) that cause activation of c-Jun N-terminal kinase (JNK) and transcription factor FoxO (Forkhead box O). Loss of dSesn resulted in age-associated pathologies including triglyceride accumulation, mitochondrial dysfunction, muscle degeneration and cardiac malfunction, which were prevented by pharmacological activation of AMPK or inhibition of TOR. Hence, dSesn appears to be a negative feedback regulator of TOR that integrates metabolic and stress inputs and prevents pathologies caused by chronic TOR activation, that may result from diminished autophagic clearance of damaged mitochondria, protein aggregates, or lipids.TOR (target of rapamycin) is a key protein kinase that regulates cell growth and metabolism to maintain cellular and organismal homeostasis (1-3). Insulin (Ins) and insulin-like growth factors (IGF) are major TOR activators that operate through phosphoinositide 3-kinase (PI3K) and the protein kinase AKT (2). Conversely, adenosine monophosphate activated protein kinase (AMPK), which is activated upon energy depletion, caloric restriction (CR), or genotoxic damage, is a stress-responsive inhibitor of TOR activation (2,4). TOR stimulates cell growth and anabolism by increasing protein and lipid synthesis through p70 S6 kinase (S6K), eukaryotic translation initiation factor 4E-binding protein (4E-BP), and sterol response element binding protein (SREBP) (1-3,5) and by decreasing autophagic † To whom correspondence should be addressed. karinoffice@ucsd.edu. Prolonged TOR signaling induces dSesnPersistent TOR activation in wing discs by a constitutively active form of insulin receptor (InR CA ) resulted in prominent dSesn protein accumulation, not seen in a dSesn-null larvae (Fig. 1, A to C). InR CA also induced accumulation of dSesn RNA (Fig. 1, D to F), indicating that dSesn accumulation is due to increased transcription or mRNA stabilization. As dSesn accumulation was restricted to cells in which TOR was activated, the response is likely to be cell autonomous. dSesn was also induced when TOR was chronically activated by overexpression of the small guanine triphosphatase Rheb (Fig. 1G), or clonal loss of PTEN (phosphatase and tensin homolog) or TSC1 (tuberous sclerosis complex 1) (Fig. 1, H TOR signaling generates ROS to induce dSesnIn mammals, transcription of Sesn genes is increased in cells exposed to oxidative stress (9,11) and we observed ROS accumulation, detected by oxidation of dihydroethidium (DHE), in the same region of the imaginal discs in which InR CA or Rheb were expressed (Fig. 2, A (Fig. 2F).FoxO and p53 are ROS-activated transcription factors that control mammalian Sesn genes (9-12,14). The dSesn locus contains 8 perfect FoxO-response elemen...

Summary Chronic activation of mammalian target of rapamycin complex 1 (mTORC1) and p70 S6 kinase (S6K) in response to hypernutrition contributes to obesity-associated metabolic pathologies including hepatosteatosis and insulin resistance. Sestrins are stress-inducible proteins that activate AMP-activated protein kinase (AMPK) and suppress mTORC1-S6K activity, but their role in mammalian physiology and metabolism has not been investigated. We show that Sestrin2, encoded by the Sesn2 locus whose expression is induced upon hypernutrition, maintains metabolic homeostasis in liver of obese mice. Sesn2 ablation exacerbates obesity-induced mTORC1-S6K activation, glucose intolerance, insulin resistance and hepatosteatosis, all of which are reversed by AMPK activation. Furthermore, concomitant ablation of Sesn2 and Sesn3 provokes hepatic mTORC1-S6K activation and insulin resistance even in the absence of nutritional overload and obesity. These results demonstrate an important homeostatic function for the stress-inducible Sestrin protein family in the control of mammalian lipid and glucose metabolism.

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Summary Obesity can result in insulin resistance, hepatosteatosis and non-alcoholic steatohepatitis (NASH) and increases liver cancer risk. Obesity-induced insulin resistance depends, in part, on chronic activation of mammalian target of rapamycin complex 1 (mTORC1), which also occurs in human and mouse hepatocellular carcinoma (HCC), a frequently fatal liver cancer. Correspondingly, mTORC1 inhibitors have been considered as potential NASH and HCC treatments. Using a mouse model in which high fat diet enhances HCC induction by the hepatic carcinogen DEN we examined whether mTORC1 inhibition attenuates liver inflammation and tumorigenesis. Notably, rapamycin treatment or hepatocyte-specific ablation of the specific mTORC1 subunit Raptor resulted in elevated interleukin 6 (IL-6) production, activation of STAT3 and enhanced HCC development, despite a transient reduction in hepatosteatosis. These results suggest that long term rapamycin treatment, which also increases IL-6 production in humans, is unsuitable for prevention or treatment of obesity-promoted liver cancer.