Objective
Impaired adaptive response to oxidative injuries is a fundamental
mechanism central to the pathogenesis of chronic hepatitis C (CHC). Glycogen
synthase kinase (GSK) 3β is an indispensable regulator of the
oxidative stress response. However, the exact role of GSK3β in CHC
is uncertain and was examined.
Design
GSK3β and Nrf2 signaling pathways were examined in JFH1
hepatitis C virus (HCV) infected Huh 7.5.1 hepatocytes and also in liver
biopsy specimens from CHC patients.
Results
HCV infection elicited prominent Nrf2 antioxidant response in
hepatocytes, marked by elevated expression of the Nrf2 dependent molecule
heme oxygenase-1 and subsequent protection from apoptotic cell death.
Inhibitory phosphorylation of GSK3β seems to be essential and
sufficient for HCV induced Nrf2 response. Mechanistically, GSK3β
physically associated and interacted with Nrf2 in hepatocytes. In
silico analysis revealed that Nrf2 encompasses multiple
GSK3β phosphorylation consensus motifs, denoting Nrf2 as a cognate
substrate of GSK3β. In the presence of TGFβ1, the HCV
induced GSK3β phosphorylation was blunted via a
protein phosphatase 1-dependent mechanism and the cytoprotective Nrf2
response drastically impaired. Lithium, a selective inhibitor of
GSK3β, counteracted the effects of TGFβ1. In liver biopsy
specimens from CHC patients, the expression of phosphorylated GSK3β
positively correlated with Nrf2 expression and was inversely associated with
the degree of liver injury. Moreover, CHC patients who received long-term
lithium carbonate therapy primarily for concomitant psychiatric disorders
exhibited much less liver injury, associated with enhanced hepatic
expression of Nrf2.
Conclusions
Inhibition of GSK3β exerts hepatoprotection in CHC possibly
through its direct regulation of Nrf2 antioxidant response.