Using comparative proteomic and genomic approaches, the authors identified eukaryotic translation initiation factor 5A (eIF5A) as an oncofetal molecule highly abundant in mouse embryonic livers and human hepatocellular carcinoma (HCC) cell lines. To evaluate the oncogenic role and prognostic significance of eIF5A in HCC, we investigate the expression patterns of the two isoforms (eIF5A1 and eIF5A2) in a cohort of 258 HCC cases by cDNA microarray. Both eIF5A isoforms were expressed in the tumors, and clinically correlated eIF5A1 with more numbers of tumor nodules and eIF5A2 with tumor venous infiltration in HCC. In a separate cohort of 50 HCCs, high level of eIF5A2, but not eIF5A1, was associated with elevated levels of deoxyhypusine synthase and deoxyhypusine hydroxylase that catalyze post-translational hypusination of eIF5A protein.Interestingly, N1-guanyl-1,7-diaminoheptane (GC7), which is an inhibitor for the first step of eIF5A hypusination, was shown to significantly impair the cell proliferation and invasion of primary HCC cells (HepG2 and Hep3B). To further demonstrate the tumorigenic role associated with eIF5A, a drastic reduction of cell proliferation was associated with suppression of eIF5A2 by transfecting Hep3B, H2-P and H2-M HCC cells expressing high level of this isoform using small interfering RNA (siRNA) against eIF5A2. For these assays, a milder response was usually observed in normal hepatocyte cell line. Therefore, these findings suggest that eIF5A plays an important role in HCC tumorigenesis and metastasis, and targeting eIF5A hypusination by GC7 inhibitor or eIF5A2 by RNA interference (RNAi) may offer new therapeutic alternatives to HCC patients.Eukaryotic translation initiation factor 5A (eIF5A) is one of the several identified eukaryotic translation initiation factors (eIFs). However, it differs from other eIFs in that it has a polyamine-derived amino acid, hypusine/N e -(4-amino-2-hydroxy-butyl)lysine, in its primary structure. Because eIF5A is synthesized initially as an inactive precursor, post-translational modification of hypusination is required to convert it to its active form. This modification is unique because it involves two sequential enzymatic steps that are catalyzed by deoxyhypusine synthase (DHS) and deoxyhypusine hydroxylase (DOHH). 1-3 eIF5A protein is present in the cytoplasm associating with the endoplasmic reticulum, 4 and also found in the nucleus largely attributed to the nuclear localization signal at the amino-terminal sequence of the protein. 5 A recent study also demonstrates the effects of hypusination in defining the cellular localizations of non-hypusinated and hypusinated eIF5A. The precursor of eIF5A is found in both cytoplasm and nucleus and the mature one is restricted largely in the cytoplasm. 6 The amino acid sequence of eIF5A is highly conserved in mammals 1 and two isoforms of eIF5A, namely eIF5A1 and eIF5A2, have been identified. Because each shows a differential expression pattern in a panel of human cancer cell lines, Clement and others have implica...