Increased systemic zonula occludens 1 associated with inflammation and independent biomarker in patients with hepatocellular carcinoma

Abstract

BackgroundHepatocellular carcinoma (HCC) is a frequent type of primary liver cancer, and its prevalence is increasing worldwide. Indeed, the underlying molecular mechanism is not well understood. Previous studies have shown evidence that tight junction (TJ) components were correlated with carcinogenesis and tumor development. Our aims were to determine the serum levels of tight junction protein Zonula Occludens (ZO)-1 and an inflammatory marker such as high-sensitive C-reactive protein (hs-CRP) in HCC patients compared to healthy volunteers and also to identify the association between ZO-1 and inflammation in HCC.MethodsThirty HCC patients and 30 healthy volunteers were recruited in the current study. Clinical data regarding child class, BCLC staging, the number of lesions, tumor size, absence or presence of metastasis, cirrhosis and hepatitis infection were also collected in HCC patients. Plasma ZO-1 and serum hsCRP were analyzed by EIA and ELISA respectively and biochemical parameters by autoanalyser (AU680 Beckman Coulter, USA). Furthermore, hepatic ZO-1 protein expression and tissue localization were examined.ResultsCompared to healthy individuals, the serum levels of bilirubin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyltransferase (GGT) and alkaline phosphatase (ALP) were elevated significantly (P < 0.0001) whilst serum albumin level was significantly (P < 0.0001) decreased in HCC patients. Furthermore, tight junction protein ZO-1 concentration was significantly elevated in HCC patients compared to control subjects (648 ± 183.8 vs. 396.4 ± 135.8 pg/ml, respectively; P < 0.0001). Serum hsCRP level was also significantly increased in HCC patients compared to control subjects (17.25 ± 3.57 vs. 5.54 ± 2.62 mg/L, respectively; P < 0.0001). Moreover, decreased protein expression of ZO-1 was found in liver tissue obtained from HCC patients.ConclusionOur findings show for the first time that the systemic concentration of ZO-1 was significantly elevated in HCC patients and is positively correlated with inflammatory markers. Thus, the current study showing evidence that inflammation promotes plasma ZO-1 concentration and raises the possibility that it could be used as a potential diagnostic biomarker for HCC progression.Electronic supplementary materialThe online version of this article (10.1186/s12885-018-4484-5) contains supplementary material, which is available to authorized users.

Nimbolide inhibits tumor growth by restoring hepatic tight junction protein expression and reduced inflammation in an experimental hepatocarcinogenesis

“…Similarly, although occludin -/- mice exhibited no gross anatomical defects, the gastric epithelial cells became hyperplastic after 40 wk[ 19 ]. Of note, our human study in HCC patients indicated a significant correlation between hepatic ZO-1 and high-sensitive C-reactive protein, however, the causal relationship remains unclear[ 20 ].…”

Microbiota, Inflammation, and Gut Barrier Dysfunction in HCC

“…In our previous study, we found increased systemic ZO-1 level in HCC patients reflecting increased intestinal permeability [31]. Moreover, plasma ZO-1 level was positively correlated with the inflammatory marker hs-CRP and with disease severity, suggesting inflammation drives intestinal permeability associated with HCC progression [31]. Bacterial overgrowth leads to increased production of pro-inflammatory cytokines such as TNF-α, IL-6, and IL-1β, which is mainly mediated through the TLR4-NF-kB signaling pathway, thereby promoting intestinal inflammation and HCC progression [19].…”

“…Growing evidence suggests that inflammation and TJ protein disruption are two of the key players driving increased intestinal permeability. In our previous study, we found increased systemic ZO-1 level in HCC patients reflecting increased intestinal permeability [31]. Moreover, plasma ZO-1 level was positively correlated with the inflammatory marker hs-CRP and with disease severity, suggesting inflammation drives intestinal permeability associated with HCC progression [31].…”

Tight junction protein ZO-1 in Kawasaki disease

“…Some studies have reported that tight junction ZO-1 protein was related to some diseases and could be used as an inflammatory marker. Ram et al reported that the systemic concentration of ZO-1 was significantly elevated in hepatocellular carcinoma patients and was positively correlated with inflammatory markers [32]. Meanwhile, Boer at el.…”