We have previously shown that hepatitis C virus (HCV) infection modulates the expression of forkhead box transcription factors, including FoxO1 and FoxA2, which play key roles in gluconeogenesis and -oxidation of fatty acid, respectively. The aim of the present study was to determine the role of forkhead box transcription factors in modulating lipid metabolism. HCV infection or core protein expression alone in transfected Huh7.
H epatitis C virus (HCV)is an important cause of morbidity and mortality worldwide, causing a spectrum of disease ranging from an asymptomatic carrier state to end-stage liver disease (1-4). The most important feature of HCV infection is the development of chronic hepatitis in a significant number of infected individuals and the potential for disease progression to metabolic disorders, fibrosis/cirrhosis, and hepatocellular carcinoma (1-3, 5). We have previously shown that HCV modulates signaling pathways in inducing insulin resistance (6, 7).Insulin regulates the expression of key enzymes involved in glucose and lipid metabolism by modulating the activity of specific forkhead box transcription factors (FoxO1 and FoxA2) in the liver. FoxO1 mediates the expression of genes involved in both glucose and lipid metabolism in the liver (8, 9). Insulin suppresses the expression of key gluconeogenic enzymes, including glucose 6-phosphatase (G6P) and phosphoenolpyruvate carboxykinase (PCK2), by stimulating the translocation of FoxO1 outside the nucleus (10). Increased glucose production can activate genes involved in lipid metabolism, including sterol regulatory element binding protein 1c (SREBP-1c) and fatty acid synthase (FASN).On the other hand, FoxA2 controls hepatic lipid metabolism in type 2 diabetes, improving insulin resistance (11,12). Thus, an interruption in insulin signaling may affect metabolic regulation. During chronic HCV infection, insulin resistance may elicit a vicious cycle for manipulating the functions of FoxA2, preventing optimal stimulation of normal metabolic functions of the liver. Lipid homeostasis requires balancing metabolic vectors, including lipogenesis, export, and degradation (-oxidation), a significant component of which is orchestrated by a family of membrane-bound master regulator transcription factors designated sterol regulatory element binding proteins (SREBPs) that regulate the expression of more than 30 genes involved in the synthesis and uptake of cholesterol, fatty acids, triglycerides, and phospholipids